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General NPI Number Information
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NPI Number | 1497112445
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Entity Type | Individual
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Provider Name | MR. ALLAN AVILA CASTILLO
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Gender | Male
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 305 E 161ST ST
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City | BRONX
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State | NY
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Zip | 10451-3535
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Country | US
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Telephone | 718-579-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 WALLACE AVE APT 577
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City | BRONX
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State | NY
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Zip | 10462-2511
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Country | US
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Telephone | 917-615-4062
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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