Provider Demographics
NPI:1568012839
Name:RICHARD M. KASTELIC, MD & ASSOC., P.C./SPECIALISTS
Entity Type:Organization
Organization Name:RICHARD M. KASTELIC, MD & ASSOC., P.C./SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KASTELIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-288-4498
Mailing Address - Street 1:322 WARREN STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-3443
Mailing Address - Country:US
Mailing Address - Phone:814-288-4498
Mailing Address - Fax:814-288-1525
Practice Address - Street 1:322 WARREN STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-3443
Practice Address - Country:US
Practice Address - Phone:814-288-4498
Practice Address - Fax:814-288-1525
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD M. KASTELIC, MD & ASSOC., P.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty