Provider Demographics
NPI:1912166877
Name:CASAGRANDE, LISETTE HELENE (MD)
Entity Type:Individual
Prefix:DR
First Name:LISETTE
Middle Name:HELENE
Last Name:CASAGRANDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 NORTHFIELD AVE
Mailing Address - Street 2:WEST ORANGE
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1194
Mailing Address - Country:US
Mailing Address - Phone:973-992-9022
Mailing Address - Fax:973-992-9024
Practice Address - Street 1:767 NORTHFIELD AVE
Practice Address - Street 2:WEST ORANGE
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1194
Practice Address - Country:US
Practice Address - Phone:973-992-9022
Practice Address - Fax:973-992-9024
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252202207RN0300X, 207R00000X
NJ25MA09899000207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine