Provider Demographics
NPI:1124023650
Name:NICASTRO, BETH M (PNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:M
Last Name:NICASTRO
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 OLEAN ST
Mailing Address - Street 2:STE 210
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2531
Mailing Address - Country:US
Mailing Address - Phone:716-652-0237
Mailing Address - Fax:716-652-0983
Practice Address - Street 1:94 OLEAN ST
Practice Address - Street 2:STE 210
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2531
Practice Address - Country:US
Practice Address - Phone:716-652-0237
Practice Address - Fax:716-652-0983
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380732164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse