1881615771 NPI number — CASTLEROCK, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881615771 NPI number — CASTLEROCK, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CASTLEROCK, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
M. KATHERINE DOWD, MD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881615771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 E NEW YORK AVE
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
SOMERS POINT
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08244-2367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-926-2021
Provider Business Mailing Address Fax Number:
609-926-2022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 E NEW YORK AVE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
SOMERS POINT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08244-2367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-926-2021
Provider Business Practice Location Address Fax Number:
609-926-2022
Provider Enumeration Date:
07/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DOWD
Authorized Official First Name:
M.
Authorized Official Middle Name:
KATHERINE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
609-926-2021

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  25MA04583300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0149900 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 043831 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 043831 . This is a "PENNSYLVANIA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0068756 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0368867000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0149900 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: F15687 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P412960 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 060042448 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: NJ0015032 . This is a "TRICARE HEALTHNET FEDERAL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1086125 . This is a "LOCAL 825 OPERATING ENGIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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