Provider Demographics
NPI:1639381825
Name:CASINI, ALBERT J JR (PT)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:J
Last Name:CASINI
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8665 S EASTERN AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2801
Mailing Address - Country:US
Mailing Address - Phone:702-330-3073
Mailing Address - Fax:702-509-5386
Practice Address - Street 1:8665 S EASTERN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2801
Practice Address - Country:US
Practice Address - Phone:702-330-3073
Practice Address - Fax:702-509-5386
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPT0375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003402083Medicaid
NVV36885Medicare PIN
NVAO283ZMedicare PIN