Provider Demographics
NPI:1053645275
Name:CASTELLO CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:CASTELLO CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-462-8200
Mailing Address - Street 1:26 IBM RD
Mailing Address - Street 2:SUITE105
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5427
Mailing Address - Country:US
Mailing Address - Phone:845-462-8200
Mailing Address - Fax:845-462-8202
Practice Address - Street 1:26 IBM RD
Practice Address - Street 2:SUITE105
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5427
Practice Address - Country:US
Practice Address - Phone:845-462-8200
Practice Address - Fax:845-462-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0048341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty