MEDICARE: DIEGO A CASTELLOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1144151333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIEGO A CASTELLOT

Provider Business Mailing Address
First Line	:	3296 ZELSNACK RD
Second Line	:
City	:	MARATHON
State	:	NY
Zip	:	13803-2240
Country	:	US
Telephone Number	:	585-645-7110
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 PERRY CREEK RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-5704
Country	:	US
Telephone Number	:	585-645-7110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ DIEGO A CASTELLOT ” Practice Location

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