Provider Demographics
NPI:1275787608
Name:HASTIE, JONATHAN MARK (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:MARK
Last Name:HASTIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:NEW YORK PRESBYTERIAN HOSPITAL, DEPT. OF ANESTHESIOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-9876
Mailing Address - Fax:914-709-8165
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:NEW YORK PRESBYTERIAN HOSPITAL DEPT. OF ANESTHESIOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-9876
Practice Address - Fax:914-709-8165
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY244441207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology