Provider Demographics
NPI:1821728411
Name:CASTRO, JENNA MARIE (DNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:MARIE
Last Name:CASTRO
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Gender:F
Credentials:DNP
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Mailing Address - Street 1:43 WESTCHESTER AVENUE
Mailing Address - Street 2:2ND FLOOR STE 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:646-762-2573
Mailing Address - Fax:646-762-2574
Practice Address - Street 1:1918 HEIGHT AVENUE
Practice Address - Street 2:2A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:347-657-3149
Practice Address - Fax:646-762-2574
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
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Provider Licenses
StateLicense IDTaxonomies
NY622155363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner