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General NPI Number Information
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NPI Number | 1902893100
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Entity Type | Individual
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Provider Name | ILENE SUE CASTALDO NP C
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Gender | Female
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 2070 ROUTE 52
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City | EAST FISHKILL
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State | NY
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Zip | 12533-3507
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Country | US
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Telephone | 845-894-5247
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Fax |
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Provider Business Mailing Address
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Address Line | 2 FARM MEADOW LN
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City | MONTGOMERY
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State | NY
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Zip | 12549-2100
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Country | US
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Telephone | 845-220-8331
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F3344901
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License Number State | NY
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