Provider Demographics
NPI:1558312041
Name:CASTELBUONO, ANTHONY C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:C
Last Name:CASTELBUONO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC DEPARTMENT OF OPHTHALMOLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:630-650-8755
Mailing Address - Fax:603-650-4434
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC DEPARTMENT OF OPHTHALMOLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:630-650-8755
Practice Address - Fax:603-650-4434
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD56831207W00000X
NH14702207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD180042053OtherR/R MEDICARE GROUP #
MDCC3778OtherR/R MEDICARE GROUP #
MD259371800Medicaid
MD180042053OtherR/R MEDICARE GROUP #
H19220Medicare UPIN