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General NPI Number Information
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NPI Number | 1528322542
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Entity Type | Individual
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Provider Name | JORGE ERNESTO CASTILLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 08/12/2016
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Provider Practice Location Address
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Address Line | 9005 OLD RIVER ROAD CENTRAL NEW YORK PSYCHIATRIC CENTER
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City | MARCY
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State | NY
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Zip | 13403
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Country | US
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Telephone | 845-398-7071
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Fax | 845-398-7066
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Provider Business Mailing Address
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Address Line | P.O. BOX 300 CENTRAL NEW YORK PSYCHIATRIC CENTER
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City | MARCY
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State | NY
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Zip | 13403
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Country | US
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Telephone | 845-398-7071
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Fax | 845-398-7066
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 279334
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License Number State | NY
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