Provider Demographics
NPI:1497522767
Name:CELESTIN, ROSE ANDREE
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ANDREE
Last Name:CELESTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:CELESTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:2 FIRST AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1106
Mailing Address - Country:US
Mailing Address - Phone:845-680-4045
Mailing Address - Fax:
Practice Address - Street 1:2 1ST AVE
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1106
Practice Address - Country:US
Practice Address - Phone:845-680-4035
Practice Address - Fax:845-680-8902
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY510893163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent