Provider Demographics
NPI:1215745278
Name:CELESTE, MICHELE MARGARET (LPN)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:MARGARET
Last Name:CELESTE
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 1:5361 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:SANBORN
Mailing Address - State:NY
Mailing Address - Zip Code:14132-9370
Mailing Address - Country:US
Mailing Address - Phone:716-524-0930
Mailing Address - Fax:
Practice Address - Street 1:5180 TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:NY
Practice Address - Zip Code:14132-9304
Practice Address - Country:US
Practice Address - Phone:716-524-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289745-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse