Provider Demographics
NPI:1235412065
Name:CASTRO, SYLVIA (LMT)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2802
Mailing Address - Country:US
Mailing Address - Phone:845-629-8529
Mailing Address - Fax:845-832-7082
Practice Address - Street 1:6 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2802
Practice Address - Country:US
Practice Address - Phone:845-629-8529
Practice Address - Fax:845-832-7082
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002612225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist