Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 211208 | MA |
N | 111NI0900X | Internist | 211208 | MA |
N | 207RA0201X | Internist - Allergy & Immunology | 211028 | MA |
N | 207RC0200X | Critical Care Medicine | 211028 | MA |
Y | 207RP1001X | Pulmonary Disease | 211028 | MA |
NPI | 1669463303 |
---|---|
Provider Name | Plutarco E Castellanos |
First Address | Leominster, MA 01453 |
Second Address | Leominster, MA 01453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 06/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0167801 | (05) | MA |
H57965 | (02) | MA |
M20928 | GROUP MEDICAL (01) |