Provider Demographics
NPI:1730958745
Name:TOURO COLLEGE OF OSTEOPATHIC MEDICINE OMM CLINIC
Entity type:Organization
Organization Name:TOURO COLLEGE OF OSTEOPATHIC MEDICINE OMM CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR, OMM CLINIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO-NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:845-933-7500
Mailing Address - Street 1:60 PROSPECT AVENUE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940
Mailing Address - Country:US
Mailing Address - Phone:845-933-7500
Mailing Address - Fax:845-933-7509
Practice Address - Street 1:60 PROSPECT AVENUE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-933-7500
Practice Address - Fax:845-933-7509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty