MEDICARE: DR. NEMESIA G. CASTRO M.D.

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	103TP0016X	Prescribing (Medical) Psychologist	MD031618-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174735518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEMESIA G. CASTRO M.D.

Provider Business Mailing Address
First Line	:	578 COACH RD
Second Line	:
City	:	HORSHAM
State	:	PA
Zip	:	19044-1613
Country	:	US
Telephone Number	:	215-643-5499
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 RISING SUN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-2719
Country	:	US
Telephone Number	:	215-456-1453
Fax Number	:	215-456-1489

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

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	07/09/2007

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