Provider Demographics
NPI:1235536319
Name:NORTHEAST RADIATION ONCOLOGY PA
Entity Type:Organization
Organization Name:NORTHEAST RADIATION ONCOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-973-8023
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04903-0683
Mailing Address - Country:US
Mailing Address - Phone:207-873-6034
Mailing Address - Fax:207-872-9136
Practice Address - Street 1:33 WHITING HILL RD
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1021
Practice Address - Country:US
Practice Address - Phone:207-973-8198
Practice Address - Fax:207-872-9136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty