Healthcare Provider Details

I. General information

NPI: 1598601114
Provider Name (Legal Business Name): BLANCA ENA CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BARTLETT ST APT 3
ROXBURY MA
02119-1882
US

IV. Provider business mailing address

41 BARTLETT ST APT 3
ROXBURY MA
02119-1882
US

V. Phone/Fax

Practice location:
  • Phone: 617-650-6257
  • Fax:
Mailing address:
  • Phone: 617-650-6257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License NumberRN10038838
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: