Individual
JOSE CASTANEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 483-1300
(973) 483-3787
Mailing address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 483-1300
(973) 483-3787
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26 NJ000625
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194996645
444 WILLIAM STREET
NJ
01
—
1235300799
37 N DAY
NJ
01
—
1548431091
982 BROAD STREET
NJ
01
—
1740345693
741 BROADWAY
NJ
01
—
1932370483
101 LUDLOW STREET
NJ
01
—
1972778413
1150 SPRINGFIELD AVE
NJ
01
—
26NO011929300
STATE LICENSE
NJ
Enumeration date
11/21/2006
Last updated
03/05/2012
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