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NPI Code Detail

MEDICARE: DIANA MARCELA CANDAMIL CASTRO

MEDICARE: DIANA MARCELA CANDAMIL CASTRO
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
1235Z00000XSpeech-Language Pathologist036395NY
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1851104350
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA MARCELA CANDAMIL CASTRO
Provider Business Mailing Address
First Line : 7000 AUSTIN ST STE 200
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4739
Country : US
Telephone Number : 718-762-7633
Fax Number :
Provider Business Practice Location Address
First Line : 7000 AUSTIN ST STE 200
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4739
Country : US
Telephone Number : 718-762-7633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2025
Last Update Date : 03/16/2026

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Directions to “ DIANA MARCELA CANDAMIL CASTRO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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