Provider Demographics
NPI:1700173283
Name:NS MEDICAL, PLLC
Entity Type:Organization
Organization Name:NS MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BASTIDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-263-4735
Mailing Address - Street 1:73 SPRING ST RM 601
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-5802
Mailing Address - Country:US
Mailing Address - Phone:212-431-4749
Mailing Address - Fax:646-304-1278
Practice Address - Street 1:73 SPRING ST RM 601
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-5802
Practice Address - Country:US
Practice Address - Phone:212-431-4749
Practice Address - Fax:646-304-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty