Castleton Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

029846 Issued in NY

Legal business name

CASTLETON PHARMACY CORP

Practice address

252 Port Richmond Ave
Staten Island, NY 10302-1749

Phone

(718) 556-0942

Fax

(718) 720-5612

NPI assigned

Mar 6, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Boris Natenzon

Title

President

Phone

(718) 720-3710

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• Enexia Specialty Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Castleton Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Castleton Pharmacy Corp

  • Community/Retail Pharmacy
  • Staten Island, NY
  • NPI 1609942614
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Marie Dimicelli, PHARM D

  • Pharmacist
  • Staten Island, NY
  • NPI 1891057998
  NPD (past)
• Polina Glazman

  • Pharmacist
  • Staten Island, NY
  • NPI 1255794343
  NPD (past)
• Diana Keddis

  • Pharmacy
  • Staten Island, NY
  • NPI 1447734330
  NPD (past)
• Ashley Beth Marinelli, PHARMD

  • Pharmacist
  • Brooklyn, NY
  • NPI 1962746099
  NPD (past)
• Stephanie Scalzo, PHARMD, RPH

  • Pharmacist
  • Staten Island, NY
  • NPI 1821562877
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1538309331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102446",
            "telephone_number": "718-720-3710",
            "fax_number": "718-360-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 PORT RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021749",
            "telephone_number": "718-556-0942",
            "fax_number": "718-720-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLETON PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-06",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "NATENZON",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-720-3710"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "029846",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029846",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119258",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enexia Specialty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mario Castellanos
• Khadijah Castello
• Katherine Castiglione, LPN
• April Castillo-Menor
• Alan Castillo, SW
• Castleton Pharmacy Corp
• Emelita Riego de Dios Castor, M.D.
• Alexandra Castris, DPT
• Cecilia R Castro, PA
• Emily C Castro, RN

• Community/Retail Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.