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General NPI Number Information
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NPI Number | 1649255365
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Entity Type | Organization
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Legal Business Name | RICHMOND OTOLARYNGOLOGY GROUP PC
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 78 TODT HILL RD SUITE 204
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4528
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Country | US
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Telephone | 718-273-2626
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Fax | 718-442-4295
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Provider Business Mailing Address
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Address Line | 78 TODT HILL RD SUITE 204
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4528
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Country | US
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Telephone | 718-273-2626
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Fax | 718-442-4295
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | DR. BARTOLOMEO V. CASTELLANO
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Credential | M.D.
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Telephone | 718-273-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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