Provider Demographics
NPI:1154665297
Name:ALVAREZ DEL CASTILLO, NICHOLAS JOSEPH (DPT)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:JOSEPH
Last Name:ALVAREZ DEL CASTILLO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:S ROYALTON
Mailing Address - State:VT
Mailing Address - Zip Code:05068-0134
Mailing Address - Country:US
Mailing Address - Phone:607-621-8518
Mailing Address - Fax:
Practice Address - Street 1:84 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4865
Practice Address - Country:US
Practice Address - Phone:802-476-3305
Practice Address - Fax:802-476-0976
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
040.0090326225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist