Provider Demographics
NPI:1740582063
Name:CASTROGIOVANNI, VIRGINIA A (RN)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:CASTROGIOVANNI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:OLIVEBRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12461-0430
Mailing Address - Country:US
Mailing Address - Phone:845-657-8155
Mailing Address - Fax:
Practice Address - Street 1:13 KELDER RD
Practice Address - Street 2:
Practice Address - City:OLIVEBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12461-5211
Practice Address - Country:US
Practice Address - Phone:845-657-8155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY514899-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse