1972888618 NPI number — MRS. BETTY P.L. CELESTIN

Table of content: MRS. BETTY P.L. CELESTIN (NPI 1972888618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972888618 NPI number — MRS. BETTY P.L. CELESTIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CELESTIN
Provider First Name:
BETTY
Provider Middle Name:
P.L.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1972888618
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3310 NOSTRAND AVE
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-715-0830
Provider Business Mailing Address Fax Number:
347-587-7810

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 METROTECH CENTER 11TH FLOOR
Provider Second Line Business Practice Location Address:
EMPIRE STATE HOME CARE SERVICES INC C/O BRIDGET O'CONNE
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-263-5824
Provider Business Practice Location Address Fax Number:
718-923-5363
Provider Enumeration Date:
10/13/2011

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: 363LP0200X , with the licence number:  F380943-1 , 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)