MEDICARE: DAVID CASTRO LMSW

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	104100000X	Social Worker	074746	NY

General Provider Information

NPI Number	:	1639392483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CASTRO LMSW

Provider Business Mailing Address
First Line	:	3354 83RD ST
Second Line	:	APT E2
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1466
Country	:	US
Telephone Number	:	917-804-6499
Fax Number	:

Provider Business Practice Location Address
First Line	:	3354 83RD ST
Second Line	:	APT E2
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1466
Country	:	US
Telephone Number	:	917-804-6499
Fax Number	:

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	03/24/2009

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Directions to “ DAVID CASTRO LMSW” Practice Location

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