Bastiaens, Leo Jan

Bastiaens, Leo Jan is an sole proprietor health care provider with primary practice located at 1620 Route 22 Ste 203 , Brewster NY 10509-4052. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Bastiaens, Leo Jan can be contacted via phone (845) 278-2500.

Contact Information

Primary practice address
1620 Route 22 Ste 203 Brewster NY 10509-4052
Phone: (845) 278-2500
Fax: (844) 454-5096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 171146 New York

Profile Details

NPI number 1235127754
LBN Legal business name Bastiaens, Leo Jan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2005
Last updated Apr 6th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235127754 NPPES
New York MEDICAID 06049783

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