Provider Demographics
NPI:1093867780
Name:CASTIGLIANO, SERGE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:SERGE
Middle Name:A
Last Name:CASTIGLIANO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CHIPPEWA RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-1504
Mailing Address - Country:US
Mailing Address - Phone:845-528-7469
Mailing Address - Fax:845-528-7469
Practice Address - Street 1:132 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2712
Practice Address - Country:US
Practice Address - Phone:516-741-0994
Practice Address - Fax:516-742-5396
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAAAPC195101YP1600X
NY002819-1101YP2500X
NY000381-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist