Provider Demographics
NPI:1003108127
Name:CASTANO, SHIRLEY (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:CASTANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16625 12TH AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2201
Mailing Address - Country:US
Mailing Address - Phone:347-804-6500
Mailing Address - Fax:718-767-1221
Practice Address - Street 1:16625 12TH AVE APT 3B
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-2201
Practice Address - Country:US
Practice Address - Phone:347-804-6500
Practice Address - Fax:718-767-1221
Is Sole Proprietor?:No
Enumeration Date:2011-05-08
Last Update Date:2011-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015014-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist