Cecilia R Castro, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

008883 Issued in NY

Practice address

475 Seaview Ave
Staten Island, NY 10305

Phone

(718) 226-6210

NPI assigned

Mar 27, 2006

Last updated

Apr 23, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Cecilia Clyburn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1801856364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 HICKS ST",
            "address_2": "APT #1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "718-596-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "CECILIA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECILIA",
            "last_name": "CLYBURN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alan Castillo, SW
• Castleton Pharmacy Corp (Enexia Specialty)
• Castleton Pharmacy Corp (Nates Pharmacy)
• Emelita Riego de Dios Castor, M.D.
• Alexandra Castris, DPT
• Emily C Castro, RN
• Judith D Castro, D.C.
• Kayla Castro
• Michelle Castro, NP-C
• Stephanie L Castro, MA

• Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.