Provider Demographics
NPI:1134217086
Name:CASTANO, LOURDES (MD)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:CASTANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 APPLECROSS RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374
Mailing Address - Country:US
Mailing Address - Phone:910-692-7928
Mailing Address - Fax:910-692-5962
Practice Address - Street 1:145 APPLECROSS RD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374
Practice Address - Country:US
Practice Address - Phone:910-692-7928
Practice Address - Fax:910-692-5962
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185462174400000X
NC2015-01807207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYOD2150OtherHEALTHNET
NY4129782OtherMVP
NY508C81OtherEMPIRE
NY49529OtherCIGNA
NYWP440OtherOXFORD
NYOD2150OtherHEALTHNET
NYWP440OtherOXFORD