Provider Demographics
NPI:1558938951
Name:CASEY, REBECCA (APN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HILL RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1078
Mailing Address - Country:US
Mailing Address - Phone:973-335-9909
Mailing Address - Fax:973-335-9910
Practice Address - Street 1:22 HILL RD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1078
Practice Address - Country:US
Practice Address - Phone:973-335-9909
Practice Address - Fax:973-335-9910
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-05
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01136500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ01136500OtherNJ LICENSE