Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 015014-1 | NY |
NPI | 1003108127 |
---|---|
Provider Name | Ms. Shirley Castano |
First Address | Whitestone, NY 11357-2201 |
Second Address | Whitestone, NY 11357-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2011 |
Last Update Date | 08/05/2011 |