Provider Demographics
NPI:1043397532
Name:CASEY, NEIL PATRICK (OD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:PATRICK
Last Name:CASEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:44 STERLING ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1217
Mailing Address - Country:US
Mailing Address - Phone:508-835-6200
Mailing Address - Fax:508-835-3244
Practice Address - Street 1:44 STERLING ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1217
Practice Address - Country:US
Practice Address - Phone:508-835-6200
Practice Address - Fax:508-835-3244
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0356298Medicaid