Provider Demographics
NPI:1881492130
Name:CASADONTE, JENNIFER MARIE (PA)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:MARIE
Last Name:CASADONTE
Suffix:
Gender:
Credentials:PA
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Mailing Address - Street 1:36 MORTON ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4086
Mailing Address - Country:US
Mailing Address - Phone:516-993-2928
Mailing Address - Fax:
Practice Address - Street 1:36 MORTON ST APT 3C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4086
Practice Address - Country:US
Practice Address - Phone:516-993-2928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant