Healthcare Provider Details

I. General information

NPI: 1255443115
Provider Name (Legal Business Name): RICHARD SCOTT CASTALDO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 TENTH STREET
NIAGARA FALLS NY
14302
US

IV. Provider business mailing address

621 10TH ST
NIAGARA FALLS NY
14301-1813
US

V. Phone/Fax

Practice location:
  • Phone: 716-278-4000
  • Fax:
Mailing address:
  • Phone: 716-278-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number188421-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number188421-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: