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General NPI Number Information
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NPI Number | 1174200240
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Entity Type | Organization
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Legal Business Name | MICHAEL CASTANIA
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 345 HILLMAN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3329
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Country | US
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Telephone | 917-566-8137
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Fax |
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Provider Business Mailing Address
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Address Line | 345 HILLMAN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3329
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Country | US
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Telephone | 917-566-8137
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL CASTANIA
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Credential |
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Telephone | 917-566-8137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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