Healthcare Provider Details

I. General information

NPI: 1619964509
Provider Name (Legal Business Name): LOUIS PATRICK BELCASTRO D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 JUDITH LN
OCEANSIDE NY
11572-4210
US

IV. Provider business mailing address

3 QUAIL HILL RD
LLOYD HARBOR NY
11743-1020
US

V. Phone/Fax

Practice location:
  • Phone: 516-764-0031
  • Fax:
Mailing address:
  • Phone: 917-972-4802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number006073
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: