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General NPI Number Information
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NPI Number | 1275712978
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Entity Type | Organization
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Legal Business Name | GISELE CASTELLUBER PA
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 477 STUYVESANT AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-2625
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Country | US
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Telephone | 201-933-2333
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Fax | 201-933-3885
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Provider Business Mailing Address
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Address Line | 477 STUYVESANT AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-2625
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Country | US
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Telephone | 201-933-2333
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Fax | 201-933-3885
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GISELE B CASTELLUBER
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Credential | MD
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Telephone | 201-933-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MA68373
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License Number State | NJ
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