Decastro, Lara Michaela

Decastro, Lara Michaela is an individual health care provider with primary practice located at 815 Hallock Ave Ste A , Port Jefferson Station NY 11776-1244. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Decastro, Lara Michaela can be contacted via phone (631) 828-3036.

Contact Information

Primary practice address
815 Hallock Ave Ste A Port Jefferson Station NY 11776-1244
Phone: (631) 828-3036
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1518665553
LBN Legal business name Decastro, Lara Michaela
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2023
Last updated Feb 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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