Healthcare Provider Details

I. General information

NPI: 1831276294
Provider Name (Legal Business Name): CHRISTINE C CASTILLO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WHITEHORSE MERCERVILLE ROAD SUITE 103
HAMILTON NJ
08619-3834
US

IV. Provider business mailing address

1445 WHITEHORSE MERCERVILLE RD STE 103
HAMILTON NJ
08619-3834
US

V. Phone/Fax

Practice location:
  • Phone: 609-587-6661
  • Fax: 609-587-8503
Mailing address:
  • Phone: 609-587-6661
  • Fax: 609-587-8503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMB072166
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB07216600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: