Provider Demographics
NPI:1932676756
Name:CASTAGNA, MATTHEW M (PA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:M
Last Name:CASTAGNA
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:33 MAGOTHY BEACH RD STE 102-103
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4413
Mailing Address - Country:US
Mailing Address - Phone:410-255-7900
Mailing Address - Fax:410-255-7300
Practice Address - Street 1:33 MAGOTHY BEACH RD STE 102-103
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4413
Practice Address - Country:US
Practice Address - Phone:410-255-7900
Practice Address - Fax:410-255-7300
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYC0006984363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant