Provider Demographics
NPI:1952584393
Name:DR LESLEY CASTELLINI
Entity type:Organization
Organization Name:DR LESLEY CASTELLINI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASTELLINI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC DC
Authorized Official - Phone:732-219-1900
Mailing Address - Street 1:206 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2002
Mailing Address - Country:US
Mailing Address - Phone:732-219-1900
Mailing Address - Fax:732-219-0202
Practice Address - Street 1:206 BROAD ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2002
Practice Address - Country:US
Practice Address - Phone:732-219-1900
Practice Address - Fax:732-219-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00019400171100000X
225100000X
NJ38MC00193600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty