Provider Demographics
NPI:1831276294
Name:CASTILLO, CHRISTINE C (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:C
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1445 WHITEHORSE MERCERVILLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3834
Mailing Address - Country:US
Mailing Address - Phone:609-587-6661
Mailing Address - Fax:609-587-8503
Practice Address - Street 1:1445 WHITEHORSE MERCERVILLE ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3834
Practice Address - Country:US
Practice Address - Phone:609-587-6661
Practice Address - Fax:609-587-8503
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB072166207Q00000X
NJ25MB07216600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8620601Medicaid
NJH37978Medicare UPIN
NJ047954Medicare PIN