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NPI Code Detail

MEDICARE: MS. VIRGINIA MARIE SISTO-CASTAGNA P.T.

MEDICARE: MS. VIRGINIA MARIE SISTO-CASTAGNA P.T.
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
12251P0200XPediatric Physical Therapist009556NY

General Provider Information

NPI Number : 1629221122
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VIRGINIA MARIE SISTO-CASTAGNA P.T.
Provider Business Mailing Address
First Line : 37 WHITE FARM RD
Second Line :
City : WINGDALE
State : NY
Zip : 12594-1116
Country : US
Telephone Number : 845-832-6322
Fax Number :
Provider Business Practice Location Address
First Line : 15 MOUNT EBO RD S
Second Line :
City : BREWSTER
State : NY
Zip : 10509-4004
Country : US
Telephone Number : 845-940-1810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2008
Last Update Date : 10/28/2008

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