Provider Demographics
NPI:1609175538
Name:CASTILLO, NESTOR A SR (SW)
Entity Type:Individual
Prefix:MR
First Name:NESTOR
Middle Name:A
Last Name:CASTILLO
Suffix:SR
Gender:M
Credentials:SW
Other - Prefix:MR
Other - First Name:NESTOR
Other - Middle Name:A
Other - Last Name:CASTILLO
Other - Suffix:SR
Other - Last Name Type:Other Name
Other - Credentials:SW
Mailing Address - Street 1:2861 BAINBRIDGE AVE
Mailing Address - Street 2:APARTMENT #2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2803
Mailing Address - Country:US
Mailing Address - Phone:718-329-9773
Mailing Address - Fax:718-329-9773
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:FLOOR 19 NORTH 47
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9198
Practice Address - Country:US
Practice Address - Phone:212-562-8734
Practice Address - Fax:212-562-2348
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072002-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker