Provider Demographics
NPI:1902227382
Name:CASTIGLIONE, JEFFERY (PT, DPT CSCS)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:
Last Name:CASTIGLIONE
Suffix:
Gender:F
Credentials:PT, DPT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6199 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1024
Mailing Address - Country:US
Mailing Address - Phone:716-984-0649
Mailing Address - Fax:716-684-5107
Practice Address - Street 1:6199 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1024
Practice Address - Country:US
Practice Address - Phone:716-984-0649
Practice Address - Fax:716-684-5107
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist