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General NPI Number Information
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NPI Number | 1063584670
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Entity Type | Individual
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Provider Name | EMELITA RIEGO DE DIOS CASTOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 2040 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1737
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Country | US
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Telephone | 718-761-2060
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Fax | 718-982-7647
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Provider Business Mailing Address
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Address Line | 26 CROTON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3331
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Country | US
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Telephone | 718-273-8714
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 141469
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License Number State | NY
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