MEDICARE: CASTLEMAN CORP

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	173000000X	Legal Medicine	N004713	NY

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	:	1265479174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASTLEMAN CORP

Provider Business Mailing Address
First Line	:	345 CLINTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-1111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 CLINTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-1111
Country	:	US
Telephone Number	:	718-783-7300
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPREITER
Name	:	DENNIS CASTILO
Credential	:
Telephone Number	:	718-783-7300

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	08/22/2020

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Directions to “CASTLEMAN CORP ” Practice Location

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