MEDICARE: ALEXIS CASTANO

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	224Z00000X	Occupational Therapy Assistant	009344	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	:	1891295903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS CASTANO

Provider Business Mailing Address
First Line	:	6145 98TH ST APT 2J
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-1427
Country	:	US
Telephone Number	:	347-724-0953
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 E 229TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-5851
Country	:	US
Telephone Number	:	718-405-7060
Fax Number	:

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

Provider Enumeration Date	:	02/15/2018
Last Update Date	:	02/15/2018

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Directions to “ ALEXIS CASTANO ” Practice Location

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