Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeremiah Jordan Decasteele

Individual provider Independent Duty Corpsman · NPI 1508636366

Jeremiah Jordan Decasteele is an Independent Duty Corpsman in Groton, Connecticut. Practices as a sole proprietor. Licensed in Connecticut.

Licensed in
CT
In the registry since
2024

Practice location Address checks out

63 Ohio Ave
Groton, CT 06340-6106
Phone: (631) 992-0705
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X (CT)

Record details

NPI number1508636366
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 3, 2024
Last updated in NPPESJanuary 3, 2024
Certification dateJanuary 3, 2024
Mailing address63 Ohio Ave, Groton, CT 06340-6106

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