Provider Demographics
NPI:1013158732
Name:CASUCCI, ALICIA V (APRN/CPNP)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:V
Last Name:CASUCCI
Suffix:
Gender:F
Credentials:APRN/CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 OXBOW RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-7323
Mailing Address - Country:US
Mailing Address - Phone:203-610-0993
Mailing Address - Fax:
Practice Address - Street 1:1239 WINDING BRANCH CIR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-3935
Practice Address - Country:US
Practice Address - Phone:203-610-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002126163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics