Provider Demographics
NPI:1881253227
Name:CASEDONTE, JOSEPH PAUL HALL
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAUL HALL
Last Name:CASEDONTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23456 MASTICK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3713
Mailing Address - Country:US
Mailing Address - Phone:440-799-9611
Mailing Address - Fax:
Practice Address - Street 1:100 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1100
Practice Address - Country:US
Practice Address - Phone:740-587-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program