Provider Demographics
NPI:1578727798
Name:CASCIO, JENNY L (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:L
Last Name:CASCIO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 DAISY LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1263
Mailing Address - Country:US
Mailing Address - Phone:716-316-3621
Mailing Address - Fax:
Practice Address - Street 1:5330 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5360
Practice Address - Country:US
Practice Address - Phone:716-626-9016
Practice Address - Fax:716-626-4271
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401150-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health