Healthcare Provider Details

I. General information

NPI: 1124885819
Provider Name (Legal Business Name): RACHEL CASTILLO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5075 W SENECA TPKE
SYRACUSE NY
13215-3216
US

IV. Provider business mailing address

241 W BORDEN AVE
SYRACUSE NY
13205-1216
US

V. Phone/Fax

Practice location:
  • Phone: 315-449-6000
  • Fax:
Mailing address:
  • Phone: 347-614-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number796419
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number357457
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: