Provider Demographics
NPI:1114323169
Name:CASTILLO, DANIRDA (MD)
Entity Type:Individual
Prefix:
First Name:DANIRDA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 W 160TH ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-6537
Mailing Address - Country:US
Mailing Address - Phone:646-744-6164
Mailing Address - Fax:
Practice Address - Street 1:7000 AUSTIN STREET
Practice Address - Street 2:SUITE 200 ACHIEVE BEYOND
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-762-7633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist