Healthcare Provider Details

I. General information

NPI: 1457271751
Provider Name (Legal Business Name): YASMIN FERNANDA CASTRO ALVARADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 BLUE POINT AVE
BLUE POINT NY
11715-1224
US

IV. Provider business mailing address

25 2ND AVE
BRENTWOOD NY
11717-8600
US

V. Phone/Fax

Practice location:
  • Phone: 631-312-3920
  • Fax:
Mailing address:
  • Phone: 800-275-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number357233
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: