Provider Demographics
NPI:1932905627
Name:CASTILLO, KATRINA ANGELICA CRUZ (APN)
Entity type:Individual
Prefix:MISS
First Name:KATRINA ANGELICA
Middle Name:CRUZ
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:3 UNIVERSITY PLZ STE 205
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6208
Mailing Address - Country:US
Mailing Address - Phone:201-833-3599
Mailing Address - Fax:201-227-6207
Practice Address - Street 1:1150 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4863
Practice Address - Country:US
Practice Address - Phone:201-833-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15279500363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care