Healthcare Provider Details

I. General information

NPI: 1720729908
Provider Name (Legal Business Name): RAYCHEL CASTILLO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1299 MIDDLE COUNTRY RD
MIDDLE ISLAND NY
11953-2515
US

IV. Provider business mailing address

700 HICKSVILLE RD
BETHPAGE NY
11714-3471
US

V. Phone/Fax

Practice location:
  • Phone: 631-744-3303
  • Fax:
Mailing address:
  • Phone: 646-501-3229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number338580
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: