Provider Demographics
NPI:1407016603
Name:CASTRANOVA, JAMES VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:VINCENT
Last Name:CASTRANOVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 EAST HOBART AVE
Mailing Address - Street 2:
Mailing Address - City:BEACH HAVEN CREST
Mailing Address - State:NJ
Mailing Address - Zip Code:08008-3529
Mailing Address - Country:US
Mailing Address - Phone:609-494-6017
Mailing Address - Fax:
Practice Address - Street 1:26 EAST HOBART AVE
Practice Address - Street 2:
Practice Address - City:BEACH HAVEN CREST
Practice Address - State:NJ
Practice Address - Zip Code:08008-3529
Practice Address - Country:US
Practice Address - Phone:609-494-6017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA21079208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28947384IMedicaid
NJD97015Medicare UPIN
NJ28947384IMedicaid