Provider Demographics
NPI:1679855787
Name:CASTRO, DIVINIA CHRISTINE (RPH)
Entity Type:Individual
Prefix:MS
First Name:DIVINIA
Middle Name:CHRISTINE
Last Name:CASTRO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4724
Mailing Address - Country:US
Mailing Address - Phone:201-243-1804
Mailing Address - Fax:201-243-9654
Practice Address - Street 1:699 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4724
Practice Address - Country:US
Practice Address - Phone:201-243-1804
Practice Address - Fax:201-243-9654
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02530200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist