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Individual

DR. JOSE ADENAUER CASTIBLANCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
94 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3013
(860) 528-1359
(860) 528-5180
Mailing address
PO BOX 269, HARRISON, NY 10528-0269

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000930
CT
213ES0103X
Foot & Ankle Surgery Podiatrist
006624
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
25MD00320800
NJ

Other

Enumeration date
07/16/2010
Last updated
10/13/2015
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