Castro, Jennifer Susan

Castro, Jennifer Susan is an individual health care provider with primary practice located at 5415 W Genesee St Suite 301, Camillus NY 13031-2162. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Castro, Jennifer Susan can be contacted via phone (315) 487-8109.

Contact Information

Primary practice address
5415 W Genesee St Suite 301 Camillus NY 13031-2162
Phone: (315) 487-8109
Fax: (315) 487-5680
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4153431 New York

Profile Details

NPI number 1174594709
LBN Legal business name Castro, Jennifer Susan
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated Aug 17th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174594709 NPPES
New York MEDICAID 02721520

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