Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 159974 | NY |
NPI | 1104897602 |
---|---|
Provider Name | Dr. Joseph F Castellano |
First Address | Staten Island, NY 10314-6017 |
Second Address | Staten Island, NY 10314-6017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A65072 | (02) | NY |