Provider Demographics
NPI:1720227226
Name:DE CASTRO, ALBERTO LUNA (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:MR
First Name:ALBERTO
Middle Name:LUNA
Last Name:DE CASTRO
Suffix:
Gender:M
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8542 54TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4333
Mailing Address - Country:US
Mailing Address - Phone:347-837-1093
Mailing Address - Fax:
Practice Address - Street 1:80 RIVER ST STE 5A
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5619
Practice Address - Country:US
Practice Address - Phone:201-377-1888
Practice Address - Fax:201-377-1892
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY031030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist