Provider Demographics
NPI:1235329301
Name:CASEY, ELLEN S (PT)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:S
Last Name:CASEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SUNNY AYRE WAY
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5120
Mailing Address - Country:US
Mailing Address - Phone:610-584-8649
Mailing Address - Fax:
Practice Address - Street 1:1300 SUNNY AYRE WAY
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5120
Practice Address - Country:US
Practice Address - Phone:610-584-8649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015408251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health