Provider Demographics
NPI:1619377017
Name:CASTELLON, CYNTHIA
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CASTELLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 EINSTEIN LOOP
Mailing Address - Street 2:ROOM 46
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4974
Mailing Address - Country:US
Mailing Address - Phone:718-320-3082
Mailing Address - Fax:
Practice Address - Street 1:135 EINSTEIN LOOP
Practice Address - Street 2:ROOM 46
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4974
Practice Address - Country:US
Practice Address - Phone:718-320-3082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085796-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical