MEDICARE: DR. BARTOLOMEO VINCENT CASTELLANO 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	207Y00000X	Otolaryngology Physician	143837	NY

General Provider Information

NPI Number	:	1336122548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARTOLOMEO VINCENT CASTELLANO MD

Provider Business Mailing Address
First Line	:	2052 RICHMOND ROAD SUITE
Second Line	:	1C
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2149
Country	:	US
Telephone Number	:	718-273-2626
Fax Number	:	718-420-1289

Provider Business Practice Location Address
First Line	:	2052 RICHMOND RD
Second Line	:	1C
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2548
Country	:	US
Telephone Number	:	718-273-2626
Fax Number	:	718-420-1289

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/08/2014

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