MEDICARE: PETER J CASTALDI M.D.

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	207R00000X	Internal Medicine Physician	223505	MA

General Provider Information

NPI Number	:	1902891062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER J CASTALDI M.D.

Provider Business Mailing Address
First Line	:	800 WASHINGTON ST
Second Line	:	NEMC BOX # 7105
City	:	BOSTON
State	:	MA
Zip	:	02111-1552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 WASHINGTON ST
Second Line	:	BOX 63
City	:	BOSTON
State	:	MA
Zip	:	02111-1552
Country	:	US
Telephone Number	:	617-636-5000
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	09/01/2009

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