Provider Demographics
NPI:1497829675
Name:CASTRO-NUNEZ, CRISTIAN (MD)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:
Last Name:CASTRO-NUNEZ
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 1:18 ORCHARD ST
Mailing Address - Street 2:STE 100
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-5005
Mailing Address - Country:US
Mailing Address - Phone:845-467-4735
Mailing Address - Fax:845-467-4736
Practice Address - Street 1:70 DUBOIS STREET
Practice Address - Street 2:ST LUKE'S CORNWALL HOSPITAL
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4825
Practice Address - Country:US
Practice Address - Phone:845-568-2827
Practice Address - Fax:845-568-2851
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY237729-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02734421Medicaid
NY02734421Medicaid