Provider Demographics
NPI:1669181921
Name:CASTANEDA, SARA R
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:R
Last Name:CASTANEDA
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 1:68 BOUVIER AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02838-3302
Mailing Address - Country:US
Mailing Address - Phone:617-921-5886
Mailing Address - Fax:
Practice Address - Street 1:68 BOUVIER AVE # MANVILLE
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:RI
Practice Address - Zip Code:02838-3302
Practice Address - Country:US
Practice Address - Phone:617-921-5886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula