Provider Demographics
NPI:1043336613
Name:NICASTRO, OSWALDO APOLINAR (MD)
Entity type:Individual
Prefix:
First Name:OSWALDO
Middle Name:APOLINAR
Last Name:NICASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 FOULK RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3643
Mailing Address - Country:US
Mailing Address - Phone:302-334-0330
Mailing Address - Fax:302-334-0329
Practice Address - Street 1:2002 FOULK RD
Practice Address - Street 2:SUITE D
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3643
Practice Address - Country:US
Practice Address - Phone:302-334-0330
Practice Address - Fax:302-334-0329
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0008737207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1043336613Medicaid
DE185698Medicare PIN