Provider Demographics
NPI:1144383860
Name:CASIDA, NENITA RELIGION (NP)
Entity Type:Individual
Prefix:MRS
First Name:NENITA
Middle Name:RELIGION
Last Name:CASIDA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14215 26TH AVE
Mailing Address - Street 2:APT 4F
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-1751
Mailing Address - Country:US
Mailing Address - Phone:718-939-1351
Mailing Address - Fax:
Practice Address - Street 1:472 FIRST AVE
Practice Address - Street 2:8S34
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:212-562-3776
Practice Address - Fax:212-562-2670
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350162363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal