MEDICARE: MS. DANIELLE NICOLE CASEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		NY

General Provider Information

NPI Number	:	1316670003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANIELLE NICOLE CASEY

Provider Business Mailing Address
First Line	:	9119 71ST RD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6710
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9119 71ST RD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6710
Country	:	US
Telephone Number	:	917-617-3905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	07/09/2022

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