Provider Demographics
NPI:1730197419
Name:CASEY-GEE, MONICA (OD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CASEY-GEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-4239
Mailing Address - Country:US
Mailing Address - Phone:518-218-7970
Mailing Address - Fax:
Practice Address - Street 1:1660 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-4239
Practice Address - Country:US
Practice Address - Phone:518-218-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005432152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0V005432Medicaid
000499223002OtherBSNENY
10000292OtherCDPHP
383325OtherMVP
000499223002OtherBSNENY
U48125Medicare UPIN