Individual
RAFAEL CASTELLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
U
Contact information
Practice address
2445 STATE ROUTE 30, TUPPER LAKE, NY 12986-2502
(518) 359-3311
Mailing address
2445 STATE ROUTE 30, TUPPER LAKE, NY 12986-2502
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
406090
NY
Other
Enumeration date
06/11/2024
Last updated
03/02/2025
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