Provider Demographics
NPI:1013752476
Name:ZAVITZ, CASEY MICHELLE (CPNP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:MICHELLE
Last Name:ZAVITZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 499
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-0499
Mailing Address - Country:US
Mailing Address - Phone:585-335-5200
Mailing Address - Fax:585-335-8579
Practice Address - Street 1:PO BOX 499
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-0499
Practice Address - Country:US
Practice Address - Phone:585-335-5200
Practice Address - Fax:585-335-8579
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY383693363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics