Provider Demographics
NPI:1669602553
Name:CASTELLANOS MENDEZ, HUGO ROBERTO (MD)
Entity type:Individual
Prefix:
First Name:HUGO
Middle Name:ROBERTO
Last Name:CASTELLANOS MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 BROWN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6790
Mailing Address - Country:US
Mailing Address - Phone:978-478-5058
Mailing Address - Fax:978-891-3689
Practice Address - Street 1:18 KEEWAYDIN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2839
Practice Address - Country:US
Practice Address - Phone:603-898-4269
Practice Address - Fax:603-894-4582
Is Sole Proprietor?:No
Enumeration Date:2009-07-26
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI66608207V00000X
PAMT194463207V00000X
MA254340207V00000X
NH20139207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100071901Medicaid