Healthcare Provider Details

I. General information

NPI: 1457875338
Provider Name (Legal Business Name): JOSEPH WILLIAM NICASTRO PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 08/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3653 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA
23452-3418
US

IV. Provider business mailing address

1114 FAIRHAVEN RD
CHESAPEAKE VA
23322-4660
US

V. Phone/Fax

Practice location:
  • Phone: 757-463-2011
  • Fax:
Mailing address:
  • Phone: 757-297-6308
  • Fax: 757-297-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202215921
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: