Provider Demographics
NPI:1699920520
Name:CASTILLO, RHONEIL QUIZON
Entity type:Individual
Prefix:
First Name:RHONEIL
Middle Name:QUIZON
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 42ND ST FL 1
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2902
Mailing Address - Country:US
Mailing Address - Phone:917-517-9212
Mailing Address - Fax:718-606-2788
Practice Address - Street 1:2847 42ND ST FL 1
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2902
Practice Address - Country:US
Practice Address - Phone:917-517-9212
Practice Address - Fax:718-606-2788
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009395-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist