Provider Demographics
NPI:1912680083
Name:CASTRO, GREISY (MASTERS,)
Entity Type:Individual
Prefix:
First Name:GREISY
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:MASTERS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-5626
Mailing Address - Country:US
Mailing Address - Phone:646-662-7218
Mailing Address - Fax:
Practice Address - Street 1:101 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-5626
Practice Address - Country:US
Practice Address - Phone:646-662-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1736319231174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty