Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 003212 | NY |
Y | 213ES0000X | Sports Medicine | 003212 | NY |
NPI | 1023684701 |
---|---|
Provider Name | Anthony Louis Castiglione |
First Address | Saint James, NY 11780-2439 |
Second Address | Dix Hills, NY 11746-5633 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2021 |
Last Update Date | 02/06/2021 |