Provider Demographics
NPI:1982085031
Name:CASTELLANETA, KERIANN
Entity Type:Individual
Prefix:
First Name:KERIANN
Middle Name:
Last Name:CASTELLANETA
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 1:1724 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4620
Mailing Address - Country:US
Mailing Address - Phone:845-664-0778
Mailing Address - Fax:
Practice Address - Street 1:1724 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4620
Practice Address - Country:US
Practice Address - Phone:845-664-0778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator