Basic Information
| Provider Information | |||||||||
| NPI: | 1619077542 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASTRUCCI | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | MORGAN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | MORGAN | ||||||||
| OtherFirstName: | HANNAH | ||||||||
| OtherMiddleName: | DAVIS | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 43 WHITING HILL RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | BREWER | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044121006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079735035 | ||||||||
| FaxNumber: | 2079735042 | ||||||||
| Practice Location | |||||||||
| Address1: | 925 UNION ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044013051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079739980 | ||||||||
| FaxNumber: | 2079737515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 11/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 043759 | CT | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 018255 | ME | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.