Provider Demographics
NPI:1487180212
Name:CASABIANCA, ANTHONY SPARTAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:SPARTAN
Last Name:CASABIANCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CHARTER CIR
Mailing Address - Street 2:APT 5D
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-6049
Mailing Address - Country:US
Mailing Address - Phone:845-597-7872
Mailing Address - Fax:
Practice Address - Street 1:ROBERT WOOD JOHNSON MEDICAL SCHOOL
Practice Address - Street 2:MEB 527, BOX 19
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08903-0019
Practice Address - Country:US
Practice Address - Phone:732-235-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program