Provider Demographics
NPI:1508925595
Name:CASTORO, PHILIP J (DC)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:CASTORO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MAPLE PLACE
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-1144
Mailing Address - Country:US
Mailing Address - Phone:732-264-8900
Mailing Address - Fax:732-264-0156
Practice Address - Street 1:250 MAPLE PLACE
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-1144
Practice Address - Country:US
Practice Address - Phone:732-264-8900
Practice Address - Fax:732-264-0156
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00205700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor