Healthcare Provider Details

I. General information

NPI: 1871713388
Provider Name (Legal Business Name): NICOLE ROSEMARIE CASTEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 BROADWAY BARNARD COLLEGE STUDENT HEALTH SERVICES
NEW YORK NY
10027-6905
US

IV. Provider business mailing address

6828 78TH ST
MIDDLE VILLAGE NY
11379-2831
US

V. Phone/Fax

Practice location:
  • Phone: 212-854-2091
  • Fax:
Mailing address:
  • Phone: 917-225-9818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number511162
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: