Provider Demographics
NPI:1497907745
Name:CASTELLANOS, MARINA D (MPT)
Entity Type:Individual
Prefix:MS
First Name:MARINA
Middle Name:D
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 GARTH RD
Mailing Address - Street 2:UNIT D1C
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3917
Mailing Address - Country:US
Mailing Address - Phone:914-552-9639
Mailing Address - Fax:
Practice Address - Street 1:235 GARTH RD
Practice Address - Street 2:UNIT D1C
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3917
Practice Address - Country:US
Practice Address - Phone:914-552-9639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPT022745-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist