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NPI Code Detail

MEDICARE: ANGELA CASTRO-RUDON

MEDICARE: ANGELA CASTRO-RUDON
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1255973087
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA CASTRO-RUDON
Provider Business Mailing Address
First Line : 3176 DECATUR AVE APT 4B
Second Line :
City : BRONX
State : NY
Zip : 10467-4549
Country : US
Telephone Number : 347-224-3235
Fax Number :
Provider Business Practice Location Address
First Line : 160 CONVENT AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10031-9198
Country : US
Telephone Number : 718-650-7745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2019
Last Update Date : 10/14/2019

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Directions to “ ANGELA CASTRO-RUDON ” Practice Location

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