Provider Demographics
NPI:1174854905
Name:AGUILAR DEL CASTILLO, NORMA LUCILA
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:LUCILA
Last Name:AGUILAR DEL CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CROTONA AVE
Mailing Address - Street 2:APT. 2
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2947
Mailing Address - Country:US
Mailing Address - Phone:917-915-5924
Mailing Address - Fax:
Practice Address - Street 1:105 CROTONA AVE
Practice Address - Street 2:APT. 2
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2947
Practice Address - Country:US
Practice Address - Phone:917-915-5924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019181235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03730696Medicaid
CA04018A41108OtherINTERNATIONAL BENEFITS ADMINISTRATORS L.L.C.