Provider Demographics
NPI:1730313461
Name:CASIERO, DEENA COSTANZA (MD)
Entity type:Individual
Prefix:DR
First Name:DEENA
Middle Name:COSTANZA
Last Name:CASIERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEENA
Other - Middle Name:COSTANZA
Other - Last Name:PETROCELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8082
Mailing Address - Country:US
Mailing Address - Phone:860-679-7692
Mailing Address - Fax:860-679-6649
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-8082
Practice Address - Country:US
Practice Address - Phone:860-679-7692
Practice Address - Fax:860-679-6649
Is Sole Proprietor?:No
Enumeration Date:2009-05-09
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048246207R00000X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine