Basic Information
| Provider Information | |||||||||
| NPI: | 1043238124 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASTILLO | ||||||||
| FirstName: | JAIRO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7365 MAIN ST | ||||||||
| Address2: | BRIDGEPORT ANESTHESIA ASSOCIATES, P.C. | ||||||||
| City: | STRATFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066141300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033843174 | ||||||||
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| Practice Location | |||||||||
| Address1: | 267 GRANT ST | ||||||||
| Address2: | BRIDGEPORT ANESTHESIA ASSOCIATES, P.C. | ||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066102805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033843000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 10/27/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 031504 | CT | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 060855632003 | 01 | CT | CIGNA CT | OTHER | 500HBA011C1 | 01 | CT | BCBS CT | OTHER | P00321746 | 01 | CT | RAILROAD MEDICARE | OTHER | CHN604 | 01 | CT | COMMUNITY HEALTH NETWORK | OTHER | 31504 | 01 | CT | CONNECTICARE | OTHER | 95012 | 01 | CT | HEALTH NET | OTHER | A770995 | 01 | CT | OXFORD HEALTH PLANS | OTHER | 4335535 | 01 | CT | AETNA CT | OTHER | 500HBA011C1 | 01 | CT | BLUE CARE FAMILY PLAN | OTHER |