Provider Demographics
NPI:1063584670
Name:CASTOR, EMELITA RIEGO DE DIOS (MD)
Entity type:Individual
Prefix:DR
First Name:EMELITA
Middle Name:RIEGO DE DIOS
Last Name:CASTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CROTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3331
Mailing Address - Country:US
Mailing Address - Phone:718-273-8714
Mailing Address - Fax:
Practice Address - Street 1:2040 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-1737
Practice Address - Country:US
Practice Address - Phone:718-761-2060
Practice Address - Fax:718-982-7647
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141469208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics