Provider Demographics
NPI:1861572562
Name:MARCANO, ALBERT CASTRO (NP)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:CASTRO
Last Name:MARCANO
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Gender:M
Credentials:NP
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Mailing Address - Street 1:9317 ROOSEVELT AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7943
Mailing Address - Country:US
Mailing Address - Phone:718-424-1557
Mailing Address - Fax:718-424-1559
Practice Address - Street 1:9317 ROOSEVELT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7943
Practice Address - Country:US
Practice Address - Phone:718-424-1557
Practice Address - Fax:718-424-1559
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2014-07-09
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Provider Licenses
StateLicense IDTaxonomies
NYF303584363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY00246075Medicaid