Provider Demographics
NPI:1750683868
Name:KESTEN, SAMANTHA KATHERINE (WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:KATHERINE
Last Name:KESTEN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 TRAPPING WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2523
Mailing Address - Country:US
Mailing Address - Phone:914-424-5812
Mailing Address - Fax:914-741-6679
Practice Address - Street 1:6930 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4231
Practice Address - Country:US
Practice Address - Phone:718-793-1943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421013363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health