MEDICARE: DR. JAMES VINCENT CASTRANOVA 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	208D00000X	General Practice Physician	MA21079	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	:	1407016603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES VINCENT CASTRANOVA MD

Provider Business Mailing Address
First Line	:	26 EAST HOBART AVE
Second Line	:
City	:	BEACH HAVEN CREST
State	:	NJ
Zip	:	08008-3529
Country	:	US
Telephone Number	:	609-494-6017
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 EAST HOBART AVE
Second Line	:
City	:	BEACH HAVEN CREST
State	:	NJ
Zip	:	08008-3529
Country	:	US
Telephone Number	:	609-494-6017
Fax Number	:

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

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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