Provider Demographics
NPI:1659893444
Name:CASALE, NICOLETTE (OD)
Entity Type:Individual
Prefix:DR
First Name:NICOLETTE
Middle Name:
Last Name:CASALE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-7708
Mailing Address - Country:US
Mailing Address - Phone:518-788-3618
Mailing Address - Fax:
Practice Address - Street 1:1783 ROUTE 9 STE 106
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-2465
Practice Address - Country:US
Practice Address - Phone:518-782-7827
Practice Address - Fax:518-782-7820
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008662152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist