Provider Demographics
NPI:1881414357
Name:CASIMIR, JENNY
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:CASIMIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TOWER RIDGE CIR APT 225
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-2705
Mailing Address - Country:US
Mailing Address - Phone:845-263-5665
Mailing Address - Fax:
Practice Address - Street 1:2834 ROUTE 17M
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:10958-5011
Practice Address - Country:US
Practice Address - Phone:845-374-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY750951-01163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health