Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 283956 | MA |
N | 2080P0202X | Pediatric Cardiologist | ETL5309 | MA |
N | 2080P0202X | Pediatric Cardiologist | Q8849 | TX |
NPI | 1003298126 |
---|---|
Provider Name | Daniel Alexander Castellanos |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2015 |
Last Update Date | 11/03/2021 |