Provider Demographics
NPI:1811947203
Name:CASTELLANO, MICHAEL ANGELO (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANGELO
Last Name:CASTELLANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:501 SEAVIEW AVENUE
Mailing Address - Street 2:STE 102
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-980-5700
Mailing Address - Fax:718-980-5499
Practice Address - Street 1:501 SEAVIEW AVENUE
Practice Address - Street 2:STE 102
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-980-5700
Practice Address - Fax:718-980-5499
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY107251207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
65307OtherELDERPLAN
107251OtherHIP
NY00689038Medicaid
0370993002OtherCIGNA
0065307OtherGHI
107251C11OtherHEALTHFIRST
4C4193OtherTOUCHSTONE
629441OtherBLUE CROSS
90132OtherAETNA
OS115OtherOXFORD
107251C11OtherHEALTHFIRST
NY629441Medicare PIN