Provider Demographics
NPI:1114986387
Name:CASEY, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:CASEY
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 1:950 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2700
Mailing Address - Country:US
Mailing Address - Phone:203-932-5711
Mailing Address - Fax:
Practice Address - Street 1:950 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2700
Practice Address - Country:US
Practice Address - Phone:203-932-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52374207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2502067OtherAETNA
MA6179975Medicaid
MA000000020341OtherBMC
MA04-3194547OtherUNITED HEALTHCARE
MA731145OtherTUFTS
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA700044OtherCONNECTICARE
MA04-3194547OtherUNICARE/GIC
MA10228206OtherCIGNA
MA300521OtherHARVARD PILGRIM
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA04-3194547OtherCONSOLIDATED
MA04-3194547OtherPLAN VISTA
MA04-3194547OtherPRIVATE HEALTHCARE SYSTEM
MA11096OtherHEALTH NEW ENGLAND
MAJ03516OtherBCBSMA
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA04-3194547OtherGREAT-WEST
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA300521OtherHARVARD PILGRIM