Provider Demographics
NPI:1598852121
Name:CESTARO, NICOLE HILTON (DC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:HILTON
Last Name:CESTARO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 BUSINESS AVE
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-9576
Mailing Address - Country:US
Mailing Address - Phone:315-345-8166
Mailing Address - Fax:
Practice Address - Street 1:5620 BUSINESS AVE
Practice Address - Street 2:STE G7
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-9576
Practice Address - Country:US
Practice Address - Phone:315-458-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011326-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB7108Medicare PIN