MEDICARE: MS. DIANA CASTELLANO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R040452-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326173196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANA CASTELLANO LCSW

Provider Business Mailing Address
First Line	:	1049 E 96TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-2300
Country	:	US
Telephone Number	:	718-272-7179
Fax Number	:

Provider Business Practice Location Address
First Line	:	3619 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4203
Country	:	US
Telephone Number	:	718-520-6460
Fax Number	:	817-520-6460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	04/09/2008

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