Provider Demographics
NPI:1992852941
Name:CASTRO, GEORGE ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALBERT
Last Name:CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 16TH ST
Mailing Address - Street 2:SUITE LL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3746
Mailing Address - Country:US
Mailing Address - Phone:212-420-9225
Mailing Address - Fax:212-420-1241
Practice Address - Street 1:205 E 16TH ST
Practice Address - Street 2:SUITE LL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3746
Practice Address - Country:US
Practice Address - Phone:212-420-9225
Practice Address - Fax:212-420-1241
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198386207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN246426OtherWELLCARE
1046946OtherAETNA
NY198386OtherHIP
2508343OtherGHI
40C771OtherEMPIRE BCBS
NYP963442OtherOXFORD
NY01872480Medicaid
0407697OtherUNITED HEALTHCARE
1C7555OtherPHS HEALTHNET
NY1C7555OtherHEALTHNET
91001911800OtherAMERICHOICE
P12012912OtherMULTIPLAN
G73338Medicare UPIN
91001911800OtherAMERICHOICE
NY110246638Medicare PIN
NYN246426OtherWELLCARE