Provider Demographics
NPI:1518993476
Name:CASTRO, DIANA (DPM)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 E 60TH ST
Mailing Address - Street 2:A42
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1015
Mailing Address - Country:US
Mailing Address - Phone:917-744-2374
Mailing Address - Fax:
Practice Address - Street 1:43 E 60TH ST
Practice Address - Street 2:A42
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10022-1015
Practice Address - Country:US
Practice Address - Phone:917-744-2374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005687213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02182167Medicaid
NY02182167Medicaid
NYPG7802Medicare ID - Type Unspecified
NYU88119Medicare UPIN