Provider Demographics
NPI:1497345938
Name:CESTARO, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:CESTARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 MASSASOIT RD
Mailing Address - Street 2:
Mailing Address - City:EASTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02642-1509
Mailing Address - Country:US
Mailing Address - Phone:520-599-1753
Mailing Address - Fax:
Practice Address - Street 1:586 MASSASOIT RD
Practice Address - Street 2:
Practice Address - City:EASTHAM
Practice Address - State:MA
Practice Address - Zip Code:02642-1509
Practice Address - Country:US
Practice Address - Phone:520-599-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor