Basic Information
| Provider Information | |||||||||
| NPI: | 1376554626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KASTELL | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | HOWARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 760 BROADWAY | ||||||||
| Address2: | 10TH FLOOR DEPARTMENT OBS/GYN | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112065317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189638533 | ||||||||
| FaxNumber: | 7189638529 | ||||||||
| Practice Location | |||||||||
| Address1: | 240 WILLOUGHBY ST | ||||||||
| Address2: | 2ND FLOOR DPO | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112015465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189230007 | ||||||||
| FaxNumber: | 7182508449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 04/15/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 171625 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 01197933 | 05 | NY | MEDICAID |