Provider Demographics
NPI:1447692694
Name:KASTEN, JEFFREY STUART (RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:STUART
Last Name:KASTEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 WESTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-2029
Mailing Address - Country:US
Mailing Address - Phone:585-594-0503
Mailing Address - Fax:585-594-9680
Practice Address - Street 1:2040 WESTSIDE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-2029
Practice Address - Country:US
Practice Address - Phone:585-594-0503
Practice Address - Fax:585-594-9680
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046837183500000X
PARP447224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist