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General NPI Number Information
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NPI Number | 1881985174
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Entity Type | Organization
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Legal Business Name | LUIS D. CASTRO
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 1766 E 172ND ST
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City | BRONX
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State | NY
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Zip | 10472-2207
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Country | US
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Telephone | 718-918-1749
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Fax | 718-918-1769
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Provider Business Mailing Address
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Address Line | 1766 E 172ND ST
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City | BRONX
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State | NY
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Zip | 10472-2207
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Country | US
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Telephone | 718-918-1749
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Fax | 718-918-1769
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. LUIS DANILO CASTRO
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Credential |
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Telephone | 718-918-1749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 9808L001
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License Number State | NY
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