Provider Demographics
NPI:1487604724
Name:CASTRO, RAFAEL CANTOS JR
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:CANTOS
Last Name:CASTRO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RAFAEL
Other - Middle Name:C
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:240 MIDDLETOWN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1832
Practice Address - Country:US
Practice Address - Phone:215-750-2300
Practice Address - Fax:215-750-2315
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA063958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G03154Medicare UPIN