Provider Demographics
NPI:1477815538
Name:CASTRO, RODRIGO (DO)
Entity Type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:
Last Name:CASTRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 OVERLOOK RD
Mailing Address - Street 2:SUITE L01
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3570
Mailing Address - Country:US
Mailing Address - Phone:908-522-5700
Mailing Address - Fax:908-273-8014
Practice Address - Street 1:33 OVERLOOK RD
Practice Address - Street 2:SUITE L01
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3570
Practice Address - Country:US
Practice Address - Phone:908-522-5700
Practice Address - Fax:908-273-8014
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY283480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine