Provider Demographics
NPI:1982606323
Name:LOCASTRO, ROBERT (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:LOCASTRO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SMITHTOWN BYP
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2524
Mailing Address - Country:US
Mailing Address - Phone:631-724-3338
Mailing Address - Fax:631-724-2860
Practice Address - Street 1:111 SMITHTOWN BYP
Practice Address - Street 2:SUITE 103
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2524
Practice Address - Country:US
Practice Address - Phone:631-724-3338
Practice Address - Fax:631-724-2860
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003762213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00665274Medicaid
NY09464Medicare ID - Type Unspecified
NY00665274Medicaid