Provider Demographics
NPI:1881615771
Name:CASTLEROCK, INC
Entity type:Organization
Organization Name:CASTLEROCK, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:DOWD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-926-2021
Mailing Address - Street 1:10 E NEW YORK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2367
Mailing Address - Country:US
Mailing Address - Phone:609-926-2021
Mailing Address - Fax:609-926-2022
Practice Address - Street 1:10 E NEW YORK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2367
Practice Address - Country:US
Practice Address - Phone:609-926-2021
Practice Address - Fax:609-926-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04583300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0149900OtherAMERIGROUP
NJ043831OtherKEYSTONE HEALTH PLAN EAST
PA043831OtherPENNSYLVANIA BLUE SHIELD
NJ0068756OtherAETNA US HEALTHCARE
NJ0368867000OtherAMERIHEALTH
NJ0149900Medicaid
NJF15687OtherHEALTHNET
NJP412960OtherOXFORD
NJ060042448OtherRAILROAD MEDICARE
NJNJ0015032OtherTRICARE HEALTHNET FEDERAL
NJ1086125OtherLOCAL 825 OPERATING ENGIN
NJ0149900OtherAMERIGROUP
NJ0368867000OtherAMERIHEALTH
NJNJ0015032OtherTRICARE HEALTHNET FEDERAL
NJP412960OtherOXFORD
NJ0149900Medicaid
NJ=========OtherUNITED HEALTHCARE
NJ0149900Medicaid
NJ=========OtherCIGNA