MEDICARE: MR. ALBERT CASTRO MARCANO NP

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	363LP2300X	Primary Care Nurse Practitioner	F303584	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861572562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALBERT CASTRO MARCANO NP

Provider Business Mailing Address
First Line	:	9317 ROOSEVELT AVE
Second Line	:	SECOND FLOOR
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7943
Country	:	US
Telephone Number	:	718-424-1557
Fax Number	:	718-424-1559

Provider Business Practice Location Address
First Line	:	9317 ROOSEVELT AVE
Second Line	:	2ND FLOOR
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7943
Country	:	US
Telephone Number	:	718-424-1557
Fax Number	:	718-424-1559

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/09/2014

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