Provider Demographics
NPI:1407119944
Name:CARESTIA, BRETT ADAM (DO)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ADAM
Last Name:CARESTIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 NEWBURYPORT RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-1556
Mailing Address - Country:US
Mailing Address - Phone:267-566-1916
Mailing Address - Fax:215-860-2093
Practice Address - Street 1:12 NEWBURYPORT RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19053-1556
Practice Address - Country:US
Practice Address - Phone:267-566-1916
Practice Address - Fax:215-860-2093
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018164207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS018164OtherSTATE LICENSE