Healthcare Provider Details

I. General information

NPI: 1306046719
Provider Name (Legal Business Name): RICHARD J. CASTIELLO, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE 1418
CHEVY CHASE MD
20815-4404
US

IV. Provider business mailing address

5530 WISCONSIN AVE 1418
CHEVY CHASE MD
20815-4404
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-1880
  • Fax: 301-718-7372
Mailing address:
  • Phone: 301-986-1880
  • Fax: 301-718-7372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD13753
License Number StateMD

VIII. Authorized Official

Name: MS. GAYE EILEEN PASSES
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-986-1880