Provider Demographics
NPI:1376229401
Name:RAND, CASEY
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:RAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E 24TH ST APT 2J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-3910
Mailing Address - Country:US
Mailing Address - Phone:781-812-6391
Mailing Address - Fax:
Practice Address - Street 1:214 E 24TH ST APT 2J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3910
Practice Address - Country:US
Practice Address - Phone:781-812-6391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered