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General NPI Number Information
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NPI Number | 1790947687
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Entity Type | Organization
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Legal Business Name | RICHARD M. KASTELIC, MD & ASSOC., P.C.
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 322 WARREN ST SUITE 300
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City | JOHNSTOWN
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State | PA
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Zip | 15905-3443
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Country | US
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Telephone | 814-288-4498
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Fax | 814-288-1525
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Provider Business Mailing Address
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Address Line | 322 WARREN ST SUITE 300
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City | JOHNSTOWN
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State | PA
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Zip | 15905-3443
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Country | US
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Telephone | 814-288-4498
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Fax | 814-288-1525
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD M KASTELIC
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Credential | MD
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Telephone | 814-288-1418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS006299L
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License Number State | PA
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