Provider Demographics
NPI:1740253632
Name:CASEY, DEBORAH L (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:CASEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1805
Mailing Address - Country:US
Mailing Address - Phone:203-573-9512
Mailing Address - Fax:203-568-2904
Practice Address - Street 1:64 ROBBINS ST
Practice Address - Street 2:SIXTH FLOOR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2613
Practice Address - Country:US
Practice Address - Phone:203-573-6263
Practice Address - Fax:203-573-6030
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2011-10-05
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Provider Licenses
StateLicense IDTaxonomies
CT040581207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001405811Medicaid
CT001405811Medicaid
CT110009019Medicare ID - Type Unspecified