Provider Demographics
NPI:1013404565
Name:CASIMIR, ROSE N (FNP)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:N
Last Name:CASIMIR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 STONE WALL DR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3027
Mailing Address - Country:US
Mailing Address - Phone:203-274-5458
Mailing Address - Fax:
Practice Address - Street 1:59 ROXBURY RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-1283
Practice Address - Country:US
Practice Address - Phone:203-322-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTF02240029363LF0000X
CT100473163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily