Individual Professional Information |
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NPI
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1972550259
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Unique healthcare provider (clinician) ID assigned by NPPES
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PECOS UID
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1850390113
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Unique individual clinician ID assigned by PECOS
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Professional Enrollment ID
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I20061214000099
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Unique ID for the individual professional enrollment that is the source for the data in the observation
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Provider Last Name
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CASTRESANA
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Individual professional last name
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Provider First Name
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JOSUE
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Individual professional first name
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Provider Gender
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M
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The provider's gender if the provider is a person.
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Provider Credential Text
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MD
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The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
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Medical School Information |
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Medical School Name
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UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
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Individual professional's medical school
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Graduation Year
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1986
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Individual professional's medical school graduation year
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Primary Specialty
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NEPHROLOGY
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Primary medical specialty reported by the individual professional in the selected enrollment
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Secondary Specialty 1
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INTERNAL MEDICINE
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First secondary medical specialty reported by the individual professional in the selected enrollment
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All Secondary Specialties
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INTERNAL MEDICINE
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All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas
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Practice Information |
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Line 1 Street Address
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OFICINA 206 HOSPITAL GENERAL MENONITA
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Group Practice or individual's line 1 address
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Line 2 Street Address
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CARR. 14 KM 31 BARRIO RINCON SECTOR LOMAS
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Group Practice or individual's line 2 address
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City
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CAYEY
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Group Practice or individual's city
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State
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PR
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Group Practice or individual's state
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Zip Code
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007360001
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Group Practice or individual's zip code (9 digits when available)
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Phone Number
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7872636007
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Phone number is listed only when there is a single phone number available for the practice location address
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