| Doctor Name: | MRS. JENNIFER ESLER BASTIS |
| NPI Number: | 1164684015 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 707 |
| Business Practice Address: | 99 Longwater Cir Suite 100 Norwell, MA - 020611642 |
| Business Phone Number: | 7816591800 |
| Business Fax Number: | 7816597221 |
| Mailing Address: | 382 Grove St, BRAINTREE |
| State: | MA |
| Postal Code: | 021847324 |
| Phone Number: | 7818481555 |
| Fax Number: | 7818482313 |
| NPI Enumeration Date: | 07/01/2008 |
| NPI Last Update Date: | 06/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 707 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |