Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 281589 | NY |
Y | 213ES0000X | Sports Medicine | 281589 | NY |
NPI | 1194098954 |
---|---|
Provider Name | Alfred Castillo |
First Address | Brooklyn, NY 11215-3693 |
Second Address | Brooklyn, NY 11215-7247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2012 |
Last Update Date | 08/07/2020 |