MEDICARE: DR. JUDITH D CASTRO D.C.

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	111N00000X	Chiropractor	X010179	NY

General Provider Information

NPI Number	:	1346224219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH D CASTRO D.C.

Provider Business Mailing Address
First Line	:	441 CORBIN AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-1875
Country	:	US
Telephone Number	:	347-731-8020
Fax Number	:

Provider Business Practice Location Address
First Line	:	2052 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2583
Country	:	US
Telephone Number	:	347-731-8020
Fax Number	:

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	01/12/2016

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