Basic Information
| Provider Information | |||||||||
| NPI: | 1174543490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASTRONUOVO | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178511665 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 MONUMENT RD | ||||||||
| Address2: | SUITE 190 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174035060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178516454 | ||||||||
| FaxNumber: | 7178511665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 06/10/2016 | ||||||||
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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 | 208600000X | MD428911 | PA | Y | Allopathic & Osteopathic Physicians | Surgery | 2086S0129X | MD428911 | PA | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1557018 | 01 | PA | GATEWAY-WMG | OTHER | 20057885 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 205439 | 01 | PA | JOHNS HOPKINS | OTHER | 4535126 | 01 | PA | AETNA | OTHER | 007257015 | 05 | PA | MEDICAID | 2159735 | 01 | PA | MAMSI-WMG CARD SURG | OTHER | 103994 | 01 | PA | GEISINGER | OTHER | 212602 | 01 | PA | UNISON-WMG CARD SURG | OTHER | 1884268 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 50069349 | 01 | PA | CAPITAL BC-WMG CARD SURG | OTHER |