Provider Demographics
NPI:1538833298
Name:CASEY, CASSARA MARIE (RN)
Entity type:Individual
Prefix:
First Name:CASSARA
Middle Name:MARIE
Last Name:CASEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CASSARA
Other - Middle Name:
Other - Last Name:FERSCHKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPRINGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-4416
Mailing Address - Country:US
Mailing Address - Phone:774-230-2414
Mailing Address - Fax:
Practice Address - Street 1:71 HAYNES ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4188
Practice Address - Country:US
Practice Address - Phone:860-646-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT182547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse