Healthcare Provider Details

I. General information

NPI: 1720641871
Provider Name (Legal Business Name): ALEXA EMIL CASTRODAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 LIVINGSTON AVE
NEW BRUNSWICK NJ
08901-2577
US

IV. Provider business mailing address

PO BOX 635
CAGUAS PR
00726-0635
US

V. Phone/Fax

Practice location:
  • Phone: 787-240-6831
  • Fax:
Mailing address:
  • Phone: 787-240-6831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number023234
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA13084800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number023234
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: