Provider Demographics
NPI:1427358142
Name:CASTLE, ANNMARIE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ANNMARIE
Middle Name:
Last Name:CASTLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:ANNMARIE
Other - Middle Name:
Other - Last Name:CASTLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:75 HEADLINE RD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-6207
Mailing Address - Country:US
Mailing Address - Phone:631-278-3914
Mailing Address - Fax:
Practice Address - Street 1:30 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-2630
Practice Address - Country:US
Practice Address - Phone:631-278-3914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274981-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse