Healthcare Provider Details

I. General information

NPI: 1942568142
Provider Name (Legal Business Name): AMANDA CASSEL CASTRO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA CASSEL SWANK MD

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 PENNSYLVANIA AVE STE 4C
WILMINGTON DE
19806-1338
US

IV. Provider business mailing address

2300 PENNSYLVANIA AVE STE 4C
WILMINGTON DE
19806-1338
US

V. Phone/Fax

Practice location:
  • Phone: 302-635-0517
  • Fax: 570-221-6246
Mailing address:
  • Phone: 302-635-0517
  • Fax: 302-651-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberC1-0012328
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: