Healthcare Provider Details

I. General information

NPI: 1679482202
Provider Name (Legal Business Name): THOMAS KEVIN CASEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE
BOSTON MA
02215-5491
US

IV. Provider business mailing address

9 EVANS RD
MIDDLETON MA
01949-1920
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-2345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN2335847
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: