Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | LP02800 | RI |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD22942 | ME |
NPI | 1083051122 |
---|---|
Provider Name | Nadav Lelkes Kastle |
First Address | Scarborough, ME 04074-7172 |
Second Address | Scarborough, ME 04074-7172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2013 |
Last Update Date | 18/02/2021 |