Provider Demographics
NPI:1245274323
Name:CASELLI, MARK A (DPM)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:CASELLI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:294 E CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2004
Mailing Address - Country:US
Mailing Address - Phone:201-825-3692
Mailing Address - Fax:201-825-4650
Practice Address - Street 1:622 ALBANY POST RD. ROUTE 9 A
Practice Address - Street 2:VA HUDSON VALLEY HEALTH CARE SYSTEM MONTROSE CAMPUS
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4274
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN2599213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist