Provider Demographics
NPI:1588993588
Name:CASTRO CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:CASTRO CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:845-642-9365
Mailing Address - Street 1:300 N MIDDLETOWN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1262
Mailing Address - Country:US
Mailing Address - Phone:845-620-0939
Mailing Address - Fax:845-620-0940
Practice Address - Street 1:300 N MIDDLETOWN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1262
Practice Address - Country:US
Practice Address - Phone:845-620-0939
Practice Address - Fax:845-620-0940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011743-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty