Provider Demographics
NPI:1194734137
Name:CASTRO, CARYL SUE (OD)
Entity type:Individual
Prefix:DR
First Name:CARYL
Middle Name:SUE
Last Name:CASTRO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CARYL
Other - Middle Name:
Other - Last Name:NADELMAN CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2921 ERIE BLVD EAST
Mailing Address - Street 2:
Mailing Address - City:SYRACAUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224
Mailing Address - Country:US
Mailing Address - Phone:315-445-7465
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:346-78 ROUTE 25A
Practice Address - Street 2:DAVIS VISION
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778
Practice Address - Country:US
Practice Address - Phone:631-744-6800
Practice Address - Fax:631-744-6820
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT0053761152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U51515Medicare UPIN
NYC1A041Medicare ID - Type Unspecified