Provider Demographics
NPI:1174543490
Name:CASTRONUOVO, JOHN JOSEPH JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:CASTRONUOVO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-1665
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 190
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-851-6454
Practice Address - Fax:717-851-1665
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2016-06-10
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Provider Licenses
StateLicense IDTaxonomies
PAMD428911208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1557018OtherGATEWAY-WMG
PA20057885OtherAMERIHEALTH MERCY-WMG
PA205439OtherJOHNS HOPKINS
PA4535126OtherAETNA
PA007257015Medicaid
PA2159735OtherMAMSI-WMG CARD SURG
PA103994OtherGEISINGER
PA212602OtherUNISON-WMG CARD SURG
PA1884268OtherHIGHMARK BLUE SHIELD
PA50069349OtherCAPITAL BC-WMG CARD SURG
PAC55999Medicare UPIN
PA103994OtherGEISINGER