Provider Demographics
NPI:1598979155
Name:CASTILLO, EDWIN F (MD)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:F
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:95 ROUTE 73 SOUTH
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043
Mailing Address - Country:US
Mailing Address - Phone:856-768-1818
Mailing Address - Fax:856-768-2058
Practice Address - Street 1:95 ROUTE 73 SOUTH
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-768-1818
Practice Address - Fax:856-768-2058
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2016-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA034324002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCA70242Medicare UPIN