Provider Demographics
NPI:1871213090
Name:CASTILLO, ANAMARIA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANAMARIA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CHOSIN FEW WAY APT 2425
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-7248
Mailing Address - Country:US
Mailing Address - Phone:570-401-6586
Mailing Address - Fax:
Practice Address - Street 1:218 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8506
Practice Address - Country:US
Practice Address - Phone:212-756-8890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0626441223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics