Provider Demographics
NPI:1134532625
Name:HAMPTON, CELESTE (LPN)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 5TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SADDLEBROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663
Mailing Address - Country:US
Mailing Address - Phone:201-880-7755
Mailing Address - Fax:201-880-7756
Practice Address - Street 1:15 5TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-6100
Practice Address - Country:US
Practice Address - Phone:201-880-7755
Practice Address - Fax:201-880-7756
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46-5352432/000172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker