| Provider / Organization | NPI | Date Certified |
|---|---|---|
| WALCES CASTELLY | 1568006682 | 2019-10-31 |
Walces Castelly is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1568006682. Registration indicates Walces Castelly is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Medical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Medical, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, ) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Medical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Medical, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
| Entity Type | Individual |
| Provider Name | Walces Castelly PA |
| Practice Office Address | 6826 W SWEETWATER AVE PEORIA, AZ US |
| Practice Office Telephone | 3474882801 |
| Mailing Address | 20 PARK PL APT 2 IRVINGTON, NJ 071112318 US |
| Business Telephone | 3474882801 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 860 Grand Concourse Apt 1L | Bronx, NY 104512815 | 9148304866 |
| 20 Park Pl Apt 2 | Irvington, NJ 071112318 | 9737988178 |
| Code | Practice | License No State |
|---|---|---|
| 363AM0700X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Medical All Other Specialties & Provider Types Physician Assistant Medical Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | 000417-P.A.
PR |
| 363AM0700X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Medical All Other Specialties & Provider Types Physician Assistant Medical Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | 10288
AZ |