Healthcare Provider Details

I. General information

NPI: 1790525210
Provider Name (Legal Business Name): ANTHONY CASTANO PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E TANGERINE RD
ORO VALLEY AZ
85755-6213
US

IV. Provider business mailing address

3 WOODLAND RD STE 213
STONEHAM MA
02180-1711
US

V. Phone/Fax

Practice location:
  • Phone: 520-901-3500
  • Fax:
Mailing address:
  • Phone: 978-687-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA101473
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11824
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: