Provider Demographics
NPI:1124306840
Name:NUMC
Entity type:Organization
Organization Name:NUMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL INTERN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CASTELLANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-250-0152
Mailing Address - Street 1:19917 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3312
Mailing Address - Country:US
Mailing Address - Phone:646-250-0152
Mailing Address - Fax:
Practice Address - Street 1:2201 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1859
Practice Address - Country:US
Practice Address - Phone:516-572-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181470251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management