Provider Demographics
NPI:1841267358
Name:CASTELLINI, JOHN DARIUS (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DARIUS
Last Name:CASTELLINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3130
Mailing Address - Country:US
Mailing Address - Phone:732-389-1674
Mailing Address - Fax:732-389-9639
Practice Address - Street 1:920 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3130
Practice Address - Country:US
Practice Address - Phone:732-389-1674
Practice Address - Fax:732-389-9639
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00193500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3024709Medicaid
CA460889Medicare ID - Type Unspecified
NJ3024709Medicaid