Basic Information
| Provider Information | |||||||||
| NPI: | 1891024311 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RICHARD M. KASTELIC, MD & ASSOC. SPECIALISTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 322 WARREN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | JOHNSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159053443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142881418 | ||||||||
| FaxNumber: | 8142881525 | ||||||||
| Practice Location | |||||||||
| Address1: | 322 WARREN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | JOHNSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159053443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142881418 | ||||||||
| FaxNumber: | 8142881525 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2009 | ||||||||
| LastUpdateDate: | 12/11/2009 | ||||||||
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| AuthorizedOfficialLastName: | KASTELIC | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8142881418 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RP1001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207Y00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology | 2085R0202X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 207VG0400X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.