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Individual

BRETT COLEMAN LASTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, BSN

Contact information

Practice address
1104 TEANECK RD, TEANECK, NJ 07666-4800
(201) 833-2400
(201) 837-0193
Mailing address
189 ALDEN PL, ENGLEWOOD, NJ 07631-1622
(201) 697-8716

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
691840
NY
163WH0200X
Home Health Registered Nurse
691840
NY
163WI0600X
Infection Control Registered Nurse
Primary
26NR17447600
NJ

Other

Enumeration date
03/31/2018
Last updated
06/05/2023
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