Provider Demographics
NPI:1194894824
Name:KASTEN, ELAINE
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:KASTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4347
Mailing Address - Country:US
Mailing Address - Phone:804-358-1874
Mailing Address - Fax:804-278-8977
Practice Address - Street 1:1901 WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4347
Practice Address - Country:US
Practice Address - Phone:804-358-1874
Practice Address - Fax:804-278-8977
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA330735OtherOPTIMUM CHOICE
VA40463Medicaid
VA4978013Medicaid
VA7756200OtherAETNA
VA6400489OtherUNITED HEALTHCARE
VA96100OtherSOUTHERN HEALTH
VA192083Medicaid
VA192083OtherANTHEM
VA31752Medicaid