Individual
STEVEN DE CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
495 GOLD STAR HIGHWAY, SUITE 112, GROTON, CT 06340-6229
(860) 446-8254
(860) 446-8293
Mailing address
22 BURDICK LN, PAWCATUCK, CT 06379-2229
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080007620CT07
BLUE CROSS BLUE SHIELD
CT
01
—
080007620CT08
BLUE CROSS BLUE SHIELD
CT
01
—
080007620CT09
BLUE SHIELD
CT
01
—
080007620CT10
BLUE SHIELD
CT
Enumeration date
08/31/2006
Last updated
10/26/2007
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