Provider Demographics
NPI:1457510265
Name:DASCHER, CASEY M (LDN)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:M
Last Name:DASCHER
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E ALLEGHENY AVE STE 140A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4427
Mailing Address - Country:US
Mailing Address - Phone:215-926-3790
Mailing Address - Fax:215-926-3776
Practice Address - Street 1:2301 E ALLEGHENY AVE STE 140A
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4427
Practice Address - Country:US
Practice Address - Phone:215-926-3790
Practice Address - Fax:215-926-3776
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1004569133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023963130001Medicaid
PA3534257000OtherPERSONAL CHOICE BLUE CROSS
PA9676169OtherAETNA