1942278825 NPI number — GARY S KASTEN D.O.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942278825 NPI number — GARY S KASTEN D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASTEN
Provider First Name:
GARY
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942278825
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1223 B MONTAUK HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-244-2442
Provider Business Mailing Address Fax Number:
631-244-2445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1223B MONTAUK HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11769-1434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-244-2442
Provider Business Practice Location Address Fax Number:
631-244-2445
Provider Enumeration Date:
03/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  190326 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 09444486882 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: AETNA HMO . This is a "2468939" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CIGNA . This is a "4992348003" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000016193 . This is a "AFFINITY INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0298851 . This is a "GHI INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P479827 . This is a "OXFORD HEALTHPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1903261 . This is a "HIP INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C2313 . This is a "HEALTHNET INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 73775 . This is a "VYTRA INS PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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