MEDICARE: PERRY J. CASTELLANO, O.D., P.A.

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	152W00000X	Optometrist	1898	NC

General Provider Information

NPI Number	:	1558383646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERRY J. CASTELLANO, O.D., P.A.

Provider Business Mailing Address
First Line	:	5351 GINGERWOOD DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405
Country	:	US
Telephone Number	:	910-392-5707
Fax Number	:

Provider Business Practice Location Address
First Line	:	5351 GINGERWOOD DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405
Country	:	US
Telephone Number	:	910-392-5707
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PERRY J. CASTELLANO
Credential	:	O.D.
Telephone Number	:	910-392-5707

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	08/22/2020

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