Individual
NICOLE CASTELLUCCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
113 W ESSEX ST, MAYWOOD, NJ 07607-1023
(201) 487-3400
(201) 603-1993
Mailing address
123 METRO BLVD, NUTLEY, NJ 07110-6101
(973) 761-9000
(201) 603-1993
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00791700
NJ
Other
Enumeration date
07/10/2023
Last updated
06/20/2024
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