Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F307207-1 | NY |
NPI | 1003295825 |
---|---|
Provider Name | Ms. Caitlin Policastro |
First Address | Huntington, NY 11743-3881 |
Second Address | Huntington, NY 11743-3881 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2015 |
Last Update Date | 05/11/2018 |