Provider Demographics
NPI:1275539652
Name:CASLER, SUSAN (CS FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:CASLER
Suffix:
Gender:F
Credentials:CS FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 923
Mailing Address - Street 2:
Mailing Address - City:BROADALBIN
Mailing Address - State:NY
Mailing Address - Zip Code:12025-0923
Mailing Address - Country:US
Mailing Address - Phone:518-883-3121
Mailing Address - Fax:518-883-3280
Practice Address - Street 1:3768 ST HWY 30
Practice Address - Street 2:
Practice Address - City:BROADALBIN
Practice Address - State:NY
Practice Address - Zip Code:12025
Practice Address - Country:US
Practice Address - Phone:518-883-3121
Practice Address - Fax:518-883-3280
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01204493Medicaid
NY01204493Medicaid
NYR88828Medicare UPIN