Healthcare Provider Details

I. General information

NPI: 1679208292
Provider Name (Legal Business Name): KARA KAESTEL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA VANARSDAL

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 WASHINGTON AVE STE 101
ALBANY NY
12206-1056
US

IV. Provider business mailing address

1375 WASHINGTON AVE STE 101
ALBANY NY
12206-1056
US

V. Phone/Fax

Practice location:
  • Phone: 518-438-4483
  • Fax: 518-482-4201
Mailing address:
  • Phone: 518-438-4483
  • Fax: 518-482-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number028402
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: