Provider Demographics
NPI:1881922748
Name:ONIK, CASEY F (DO)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:F
Last Name:ONIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 ZAFARANO DR STE C PMB 249
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507
Mailing Address - Country:US
Mailing Address - Phone:505-500-5392
Mailing Address - Fax:505-485-0641
Practice Address - Street 1:3201 ZAFARANO DR STE C PMB 249
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507
Practice Address - Country:US
Practice Address - Phone:505-500-5392
Practice Address - Fax:505-485-0641
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1823-14204D00000X
MEA-1823-14207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMH3451Medicaid