Healthcare Provider Details

I. General information

NPI: 1538895313
Provider Name (Legal Business Name): CAITLIN RASTANI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 GENESEE ST STE B1
UTICA NY
13502-4617
US

IV. Provider business mailing address

6593 MALLORY RD
UTICA NY
13502-6707
US

V. Phone/Fax

Practice location:
  • Phone: 315-801-7140
  • Fax:
Mailing address:
  • Phone: 315-794-3799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71018288A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number349924
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: