Provider Demographics
NPI:1306382601
Name:CASTOR, CHIMENE (RDN, LDN, CHES)
Entity Type:Individual
Prefix:DR
First Name:CHIMENE
Middle Name:
Last Name:CASTOR
Suffix:
Gender:F
Credentials:RDN, LDN, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6218 BLACK CHERRY CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4462
Mailing Address - Country:US
Mailing Address - Phone:410-707-2779
Mailing Address - Fax:
Practice Address - Street 1:6218 BLACK CHERRY CIRCLE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:410-707-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI10000575133NN1002X
MDD02091133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education