Provider Demographics
NPI:1528322542
Name:CASTILLO, JORGE ERNESTO (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ERNESTO
Last Name:CASTILLO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:P.O. BOX 300
Mailing Address - Street 2:CENTRAL NEW YORK PSYCHIATRIC CENTER
Mailing Address - City:MARCY
Mailing Address - State:NY
Mailing Address - Zip Code:13403
Mailing Address - Country:US
Mailing Address - Phone:845-398-7071
Mailing Address - Fax:845-398-7066
Practice Address - Street 1:9005 OLD RIVER ROAD
Practice Address - Street 2:CENTRAL NEW YORK PSYCHIATRIC CENTER
Practice Address - City:MARCY
Practice Address - State:NY
Practice Address - Zip Code:13403
Practice Address - Country:US
Practice Address - Phone:845-398-7071
Practice Address - Fax:845-398-7066
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2016-08-12
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Provider Licenses
StateLicense IDTaxonomies
NY2793342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry