Provider Demographics
NPI:1952775801
Name:CASTMA, NAIKA CLARA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:NAIKA
Middle Name:CLARA
Last Name:CASTMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 KERNOCHAN AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4518
Mailing Address - Country:US
Mailing Address - Phone:516-234-4796
Mailing Address - Fax:
Practice Address - Street 1:380 N BROADWAY
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2115
Practice Address - Country:US
Practice Address - Phone:516-931-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019325363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant