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Individual

ANDRES CASTILLO OJEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6637
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(572) 663-7516

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
073004286
PASSPORT
01
772796133
DRIVER LICENSE
NY
Enumeration date
06/22/2018
Last updated
06/22/2018
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