Healthcare Provider Details

I. General information

NPI: 1134335813
Provider Name (Legal Business Name): FRANKLIN RODNEY CASAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FULTON AVE
HEMPSTEAD NY
11550-3718
US

IV. Provider business mailing address

308 PAMLICO AVE
UNIONDALE NY
11553-1754
US

V. Phone/Fax

Practice location:
  • Phone: 516-481-0052
  • Fax: 516-481-2115
Mailing address:
  • Phone: 516-676-2388
  • Fax: 516-759-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: