1174854905 NPI number — MRS. NORMA LUCILA AGUILAR DEL CASTILLO

Table of content: (NPI 1154873909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174854905 NPI number — MRS. NORMA LUCILA AGUILAR DEL CASTILLO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AGUILAR DEL CASTILLO
Provider First Name:
NORMA
Provider Middle Name:
LUCILA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174854905
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 CROTONA AVE
Provider Second Line Business Mailing Address:
APT. 2
Provider Business Mailing Address City Name:
HARRISON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10528-2947
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-915-5924
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 CROTONA AVE
Provider Second Line Business Practice Location Address:
APT. 2
Provider Business Practice Location Address City Name:
HARRISON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10528-2947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-915-5924
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  019181 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03730696 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04018A41108 . This is a "INTERNATIONAL BENEFITS ADMINISTRATORS L.L.C." identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com