Provider Demographics
NPI:1396507489
Name:LOCASTRO, KAYLEE MICHELE
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:MICHELE
Last Name:LOCASTRO
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 1:66 LETCHWORTH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-5599
Mailing Address - Country:US
Mailing Address - Phone:315-255-8725
Mailing Address - Fax:
Practice Address - Street 1:66 LETCHWORTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-5599
Practice Address - Country:US
Practice Address - Phone:315-255-8721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY734875163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse