Provider Demographics
NPI:1790527505
Name:NYAME, CASTRO (CEO)
Entity type:Individual
Prefix:
First Name:CASTRO
Middle Name:
Last Name:NYAME
Suffix:
Gender:M
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-2311
Mailing Address - Country:US
Mailing Address - Phone:774-253-7418
Mailing Address - Fax:
Practice Address - Street 1:84 CONCORD ST
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-2311
Practice Address - Country:US
Practice Address - Phone:774-253-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other