Provider Demographics
NPI:1194179606
Name:CASTELLANI, DEANE FRANCIS (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:DEANE
Middle Name:FRANCIS
Last Name:CASTELLANI
Suffix:
Gender:M
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 N JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-3325
Mailing Address - Country:US
Mailing Address - Phone:609-576-0820
Mailing Address - Fax:
Practice Address - Street 1:49 N JACKSON AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-3325
Practice Address - Country:US
Practice Address - Phone:609-576-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00586400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist