Guillermo De Jesus Castillo

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

033605 Issued in NY

Practice address

501 Chestnut Ridge Rd Ste 205
Chestnut Ridge, NY 10977-5669

Phone

(845) 638-3072

NPI assigned

Jan 10, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1003456757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 DUMONT AVE",
            "city": "DUMONT",
            "state": "NJ",
            "postal_code": "076283018",
            "telephone_number": "718-679-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CHESTNUT RIDGE RD STE 205",
            "city": "CHESTNUT RIDGE",
            "state": "NY",
            "postal_code": "109775669",
            "telephone_number": "845-638-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "GUILLERMO",
        "middle_name": "DE JESUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-10",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "033605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina Brucculeri, PHARMD
• Denise Bullock, MSED
• Jeffrey Michael Burger
• Judy Lynn Burns, LCSW
• John Caputo
• Chestnut Ridge Wellness Medicine PLLC
• Serrah Choi
• Carminda Clemente
• Allison Curry, OTR/L
• Galilee G Damiao, M.S. OTR/L

• Speech-Language Pathologist in Chestnut Ridge, NY
• Providers in Chestnut Ridge, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.