Provider Demographics
NPI:1447639141
Name:CASTAIN - BARTON, TERESA (LPN)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:CASTAIN - BARTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 DEER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3420
Mailing Address - Country:US
Mailing Address - Phone:631-855-5532
Mailing Address - Fax:
Practice Address - Street 1:154 DEER LAKE DR
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3420
Practice Address - Country:US
Practice Address - Phone:631-855-5532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320012164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse