MEDICARE: DR. GREGORIO CASTILLO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	25MA06768600	NJ

General Provider Information

NPI Number	:	1013095306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORIO CASTILLO MD

Provider Business Mailing Address
First Line	:	1460 LIVINGSTON AVE
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-1873
Country	:	US
Telephone Number	:	732-729-3618
Fax Number	:	609-683-6817

Provider Business Practice Location Address
First Line	:	1460 LIVINGSTON AVE
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-1873
Country	:	US
Telephone Number	:	732-729-3600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	08/02/2024

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