Healthcare Provider Details

I. General information

NPI: 1336485309
Provider Name (Legal Business Name): CHRISTOPHER RALPH CASTELLANO PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2012
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E FRONT ST FL 5
RED BANK NJ
07701-1851
US

IV. Provider business mailing address

70 E FRONT ST FL 5
RED BANK NJ
07701-1851
US

V. Phone/Fax

Practice location:
  • Phone: 908-340-2746
  • Fax: 908-498-5045
Mailing address:
  • Phone: 908-340-2746
  • Fax: 908-498-5045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00295000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: