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NPI Code Detail

MEDICARE: MS. NICOLE DANIELLE CASTELLANO LMSW

MEDICARE: MS. NICOLE DANIELLE CASTELLANO LMSW
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
1104100000XSocial Worker44SL06795900NJ
2104100000XSocial Worker112263NY

General Provider Information

NPI Number : 1316679186
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE DANIELLE CASTELLANO LMSW
Provider Business Mailing Address
First Line : 50 BAY ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-2511
Country : US
Telephone Number : 718-447-7740
Fax Number :
Provider Business Practice Location Address
First Line : 50 BAY ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-2511
Country : US
Telephone Number : 718-447-7740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2022
Last Update Date : 06/29/2022

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