Provider Demographics
NPI:1750308185
Name:DUCA, CASEY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:LEE
Last Name:DUCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 INTREPID LANE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205
Mailing Address - Country:US
Mailing Address - Phone:315-469-8191
Mailing Address - Fax:315-469-4482
Practice Address - Street 1:151 INTREPID LN
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-2552
Practice Address - Country:US
Practice Address - Phone:315-469-8191
Practice Address - Fax:315-469-4482
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228571208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH85816Medicare UPIN
NYDD5905Medicare ID - Type Unspecified