Most Relevant Information
Provider Data
| NPI Number: | 1003456757 |
| Provider Name: | GUILLERMO DE JESUS CASTILLO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/10/2020 |
| Last Updated: | 09/28/2023 |
Provider Practice Location
501 CHESTNUT RIDGE RD STE 205
CHESTNUT RIDGE
NY
109775669
Practice Location Phone/Fax
| Phone: | 8456383072 |
| Fax: |
Provider Mailing Location
66 DUMONT AVE
DUMONT
NJ
076283018
Provider Mailing Phone/Fax
| Phone: | 7186792644 |
| Fax: |