Provider Demographics
NPI:1316436629
Name:DE CASTRO, DOROTHY S (RN)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:S
Last Name:DE CASTRO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24912 JERICHO TPKE STE 220
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-4020
Mailing Address - Country:US
Mailing Address - Phone:516-448-2116
Mailing Address - Fax:516-448-2339
Practice Address - Street 1:24912 JERICHO TPKE STE 220
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-4020
Practice Address - Country:US
Practice Address - Phone:516-448-2116
Practice Address - Fax:516-448-2339
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2299881163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health