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:
Health care specialties
| Specialty | Code | License # | 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 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235127754 | NPPES |
| New York | MEDICAID | 06049783 |
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