Provider Demographics
NPI:1225567100
Name:CASTELLANO, ALEXANDRA
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:RIGOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-C
Mailing Address - Street 1:175 E MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2981
Mailing Address - Country:US
Mailing Address - Phone:631-549-5700
Mailing Address - Fax:631-549-1991
Practice Address - Street 1:175 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2939
Practice Address - Country:US
Practice Address - Phone:631-549-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY660524363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health