MEDICARE: PAMELA CASTELLI 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	077646	NY

General Provider Information

NPI Number	:	1578775797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA CASTELLI LCSW

Provider Business Mailing Address
First Line	:	6 CHYAM ST
Second Line	:
City	:	NORTH BABYLON
State	:	NY
Zip	:	11703-1402
Country	:	US
Telephone Number	:	631-836-3027
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 FIRE ISLAND AVE
Second Line	:	SUITE 103
City	:	BABYLON
State	:	NY
Zip	:	11702-3502
Country	:	US
Telephone Number	:	631-836-3027
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	04/27/2011

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