Provider Demographics
NPI:1518317627
Name:CASTRO, MARINO ANTONIO JR (MS)
Entity Type:Individual
Prefix:MR
First Name:MARINO
Middle Name:ANTONIO
Last Name:CASTRO
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 225TH ST
Mailing Address - Street 2:APT. 8H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5015
Mailing Address - Country:US
Mailing Address - Phone:914-693-3030
Mailing Address - Fax:
Practice Address - Street 1:71 BROADWAY
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2834
Practice Address - Country:US
Practice Address - Phone:914-693-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health