Provider Demographics
NPI:1316019177
Name:KASTEN, JAN (AAS)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:KASTEN
Suffix:
Gender:F
Credentials:AAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 2910
Mailing Address - Street 2:
Mailing Address - City:HALLSTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:18822
Mailing Address - Country:US
Mailing Address - Phone:607-729-0044
Mailing Address - Fax:607-729-9994
Practice Address - Street 1:700 HARRY L DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-1145
Practice Address - Country:US
Practice Address - Phone:607-729-0044
Practice Address - Fax:607-729-9994
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000684224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant