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General NPI Number Information
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NPI Number | 1316200850
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Entity Type | Individual
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Provider Name | MARY HILDEGARDE CASTLE MS SP.ED.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 4539 SUNSET BAY RD
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City | BEMUS POINT
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State | NY
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Zip | 14712-9629
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Country | US
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Telephone | 716-450-4274
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Fax | 716-386-4274
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Provider Business Mailing Address
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Address Line | 4539 SUNSET BAY RD
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City | BEMUS POINT
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State | NY
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Zip | 14712-9629
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Country | US
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Telephone | 716-450-4274
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Fax | 716-386-4274
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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