Provider Demographics
NPI:1801042304
Name:CASTELLAN CHIROPRACTIC & WELLNESS PC
Entity Type:Organization
Organization Name:CASTELLAN CHIROPRACTIC & WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:W
Authorized Official - Last Name:CASTELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-685-1728
Mailing Address - Street 1:1 W CLIFF ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1901
Mailing Address - Country:US
Mailing Address - Phone:908-685-1728
Mailing Address - Fax:908-707-1046
Practice Address - Street 1:1 W CLIFF ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1901
Practice Address - Country:US
Practice Address - Phone:908-685-1728
Practice Address - Fax:908-707-1046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00665200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty