Provider Demographics
NPI:1013588227
Name:MASTRONARDI, CASEY CHRISTINE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:CHRISTINE
Last Name:MASTRONARDI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:CASEY
Other - Middle Name:CHRISTINE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:400 WESTAGE BUSINESS CTR DR STE 109
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2231
Mailing Address - Country:US
Mailing Address - Phone:845-765-0125
Mailing Address - Fax:845-765-0128
Practice Address - Street 1:400 WESTAGE BUSINESS CTR DR STE 109
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2231
Practice Address - Country:US
Practice Address - Phone:845-765-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347699-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily