Provider Demographics
NPI:1194880997
Name:KASTEN, MARJORIE H (PT)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:H
Last Name:KASTEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:ME
Mailing Address - Zip Code:04422-3440
Mailing Address - Country:US
Mailing Address - Phone:207-941-1940
Mailing Address - Fax:207-391-7803
Practice Address - Street 1:299 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:ME
Practice Address - Zip Code:04422-3440
Practice Address - Country:US
Practice Address - Phone:207-941-1940
Practice Address - Fax:207-391-7803
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT 294225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1233884OtherCIGNA PROVIDER NUMBER
ME1041661OtherAETNA PROVIDER NUMBER
ME013020OtherBCBS STAR NUMBER
ME5451675OtherAETNA PROVIDER NUMBER
MEMN2493OtherHARVARD PILGRIM PROVIDER
ME4843646-001OtherCIGNA PROVIDER NUMBER