MEDICARE: GINA MARIE CASTELONIA 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
1	104100000X	Social Worker	108018-01	NY

General Provider Information

NPI Number	:	1437799368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA MARIE CASTELONIA LMSW

Provider Business Mailing Address
First Line	:	128 WILLOW AVE
Second Line	:
City	:	CORNWALL
State	:	NY
Zip	:	12518-1438
Country	:	US
Telephone Number	:	914-714-1240
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 US ROUTE 9W
Second Line	:
City	:	NEW WINDSOR
State	:	NY
Zip	:	12553-6756
Country	:	US
Telephone Number	:	845-562-9816
Fax Number	:

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

Provider Enumeration Date	:	01/08/2020
Last Update Date	:	01/08/2020

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