Provider Demographics
NPI:1689737959
Name:BYPASS FOOTCARE
Entity Type:Organization
Organization Name:BYPASS FOOTCARE
Other - Org Name:DR. ROBERT LOCASTRO
Other - Org Type:Other Name
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOCASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-724-3338
Mailing Address - Street 1:111 SMITHTOWN BYP
Mailing Address - Street 2:STE 103
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2524
Mailing Address - Country:US
Mailing Address - Phone:631-724-3338
Mailing Address - Fax:631-724-2860
Practice Address - Street 1:111 SMITHTOWN BYP
Practice Address - Street 2:STE 103
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2524
Practice Address - Country:US
Practice Address - Phone:631-724-3338
Practice Address - Fax:631-724-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003762213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty