Provider Demographics
NPI:1467862102
Name:CASKIE, ELLIOTT (RN)
Entity Type:Individual
Prefix:MR
First Name:ELLIOTT
Middle Name:
Last Name:CASKIE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:ELLIOTT
Other - Middle Name:
Other - Last Name:CASKIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:118 HEWITT BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-3007
Mailing Address - Country:US
Mailing Address - Phone:727-645-3398
Mailing Address - Fax:
Practice Address - Street 1:118 HEWITT BLVD
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-3007
Practice Address - Country:US
Practice Address - Phone:727-645-3398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-03
Last Update Date:2014-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY529373-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse