Provider Demographics
NPI:1740089606
Name:CASTONGUAY, SIERRA ROSE
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:ROSE
Last Name:CASTONGUAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PATRIOTS LN
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03290-5821
Mailing Address - Country:US
Mailing Address - Phone:603-303-6614
Mailing Address - Fax:
Practice Address - Street 1:96 FALMOUTH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-4864
Practice Address - Country:US
Practice Address - Phone:800-800-4876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program