Provider Demographics
NPI:1093996712
Name:KASTEN, MICHAEL F
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:KASTEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 NEW JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-2136
Mailing Address - Country:US
Mailing Address - Phone:631-803-6023
Mailing Address - Fax:
Practice Address - Street 1:140 NEW JERSEY AVE
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-2136
Practice Address - Country:US
Practice Address - Phone:631-803-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2768051164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse