Provider Demographics
NPI:1578852935
Name:ASSOCIATES MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ASSOCIATES MEDICAL CORPORATION
Other - Org Name:WILLIAM CASTILA, MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-365-1377
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07507-0030
Mailing Address - Country:US
Mailing Address - Phone:973-365-1377
Mailing Address - Fax:973-365-1229
Practice Address - Street 1:293 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5803
Practice Address - Country:US
Practice Address - Phone:973-365-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA02465100305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ477050101Medicaid
NJC56655Medicare UPIN
NJ519952Medicare PIN