Provider Demographics
NPI:1619065927
Name:BASTIEN, ARNAUD (MD)
Entity Type:Individual
Prefix:
First Name:ARNAUD
Middle Name:
Last Name:BASTIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:446 WHITE HORSE PIKE N
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:NJ
Practice Address - Zip Code:08049-1405
Practice Address - Country:US
Practice Address - Phone:856-782-7121
Practice Address - Fax:856-782-7231
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66225207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1855224OtherUNITED HEALTH CARE
P2885262OtherOXFORD HEALTH PLAN
11531OtherAMERIHEALTH PPO
19122OtherUNIVERSITY HEALTH PLAN
1009018OtherAETNA US-HEALTHCARE
1091812OtherHORIZON NJ HEALTH
110157952OtherRAIL RAOD MEDICARE
NJ7377401Medicaid
0459819000OtherAMERIHEALTH HMO, KEYSTONE, IBC
37070OtherAMERIGROUP
CA0000232 05OtherAMERICHOICE
11531OtherAMERIHEALTH PPO
001232Medicare PIN