MEDICARE: DR. LUISA RITA DEL CASTILLO MD, F.A.A.P.

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	208000000X	Pediatrics Physician	25MA05379300	NJ
2	208000000X	Pediatrics Physician	MA053793	NJ

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	:	1376549196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUISA RITA DEL CASTILLO MD, F.A.A.P.

Provider Business Mailing Address
First Line	:	530 PROSPECT AVE
Second Line	:	STE 2A
City	:	LITTLE SILVER
State	:	NJ
Zip	:	07739-1444
Country	:	US
Telephone Number	:	732-530-5515
Fax Number	:	732-530-5516

Provider Business Practice Location Address
First Line	:	225 ROUTE 35 STE 102
Second Line	:
City	:	RED BANK
State	:	NJ
Zip	:	07701-5919
Country	:	US
Telephone Number	:	732-530-5515
Fax Number	:	732-530-5516

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	09/14/2020

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