Provider Demographics
NPI:1013109222
Name:CASTILLO, CONUELITA GUERRERO (RN)
Entity Type:Individual
Prefix:
First Name:CONUELITA
Middle Name:GUERRERO
Last Name:CASTILLO
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 1:52 RAMBLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-8784
Mailing Address - Country:US
Mailing Address - Phone:845-863-0850
Mailing Address - Fax:
Practice Address - Street 1:351 E 51ST ST APT 10A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-6702
Practice Address - Country:US
Practice Address - Phone:212-758-3662
Practice Address - Fax:212-758-3729
Is Sole Proprietor?:No
Enumeration Date:2007-08-11
Last Update Date:2007-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY377581-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse