Provider Demographics
NPI:1679395859
Name:VASQUEZ DE CASTILLO, ANAIDA C
Entity type:Individual
Prefix:
First Name:ANAIDA
Middle Name:C
Last Name:VASQUEZ DE CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 PINE GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9403
Mailing Address - Country:US
Mailing Address - Phone:484-294-6832
Mailing Address - Fax:
Practice Address - Street 1:3757 CLAY DR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-9233
Practice Address - Country:US
Practice Address - Phone:718-207-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist