Provider Demographics
NPI:1912299512
Name:CASEY, DENIS JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:JOHN
Last Name:CASEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 VILLAGE VIEW BLF
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-1205
Mailing Address - Country:US
Mailing Address - Phone:518-281-7624
Mailing Address - Fax:518-281-7624
Practice Address - Street 1:19 VILLAGE VIEW BLF
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1205
Practice Address - Country:US
Practice Address - Phone:518-281-7624
Practice Address - Fax:518-281-7624
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36475183500000X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835X0200XPharmacy Service ProvidersPharmacistOncology