MEDICARE: DR. NICOLETTE CASALE OD

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	152W00000X	Optometrist	008662	NY

General Provider Information

NPI Number	:	1659893444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLETTE CASALE OD

Provider Business Mailing Address
First Line	:	20 MEADOW DR
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12180-7708
Country	:	US
Telephone Number	:	518-788-3618
Fax Number	:

Provider Business Practice Location Address
First Line	:	1783 ROUTE 9 STE 106
Second Line	:
City	:	HALFMOON
State	:	NY
Zip	:	12065-2465
Country	:	US
Telephone Number	:	518-782-7827
Fax Number	:	518-782-7820

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

Provider Enumeration Date	:	07/12/2017
Last Update Date	:	01/02/2024

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