Individual provider Active NPI

Ruth Liliana Castillo de Guzman, RN

  • Registered Nurse
  • Port Jefferson, NY
National Provider Identifier
1174763734
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
609715 Issued in NY
Practice address
37 Pinnacle Dr
Port Jefferson, NY 11777-2085
Phone
(631) 828-1150
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 609715 NY Primary

Addresses

Primary practice location

37 Pinnacle Dr
Port Jefferson, NY 11777-2085

Mailing address

37 Pinnacle Dr
Port Jefferson, NY 11777-2085
Phone (631) 828-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
609715NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1174763734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PINNACLE DR",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772085",
            "telephone_number": "631-828-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 PINNACLE DR",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772085",
            "telephone_number": "631-828-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO DE GUZMAN",
        "first_name": "RUTH",
        "middle_name": "LILIANA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "609715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.