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General NPI Number Information
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NPI Number | 1598392664
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Entity Type | Individual
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Provider Name | NATHANIEL J. GASTALDO DPM
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Gender | Male
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 910 WALLACE AVE STE 301
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City | LEITCHFIELD
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State | KY
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Zip | 42754-2418
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Country | US
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Telephone | 270-200-4545
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Fax | 270-200-4543
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Provider Business Mailing Address
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Address Line | PO BOX 23229
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City | OWENSBORO
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State | KY
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Zip | 42304-3229
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Country | US
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Telephone | 270-688-1330
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Fax | 270-688-1338
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 282971
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License Number State | KY
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