DR. Jack Bastow, DPM

NPI #1881621423 in Albany, New York

Provider Information

NPI Number: 1881621423
Entity Type: Individual
Name: DR. Jack Bastow, DPM
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Podiatrist - Foot Surgery
Credential: DPM
Enumeration Date: Jun 27, 2006
Last Updated: Jan 22, 2009

Practice Location

Address: 4 PALISADES DR
Address 2: SUITE 250A
City: Albany
State: New York
ZIP Code: 12205-1443
Phone: (518) 458-1771

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist - Foot Surgery — Foot Surgery	213ES0131X	Primary

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Organizations

Provider Name	Specialty	City
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