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Contact Information

JOHN A BASTULLI, MD
10515 CARNEGIE AVE
CLEVELAND, OH44106-3016
 Phone: 216-928-0136
 Fax: 216-928-0141
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for JOHN A BASTULLI · (Male)

NPI # 1104811264
Status Active
Credentials MD
Entity Individual
Enumeration date 09/15/2005
Last updated 10/06/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 35-05-0645
  • OH Medicaid 0703144
Hospital affiliation(s)
  • ST VINCENT CHARITY MEDICAL CENTER - (Acute Care)
    2351 EAST 22ND STREET
    CLEVELAND, OH 44115
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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