Healthcare Provider Details

I. General information

NPI: 1558038679
Provider Name (Legal Business Name): CAMILLA CASADEI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 5TH AVE
NEW YORK NY
10001-4511
US

IV. Provider business mailing address

86 WAYSIDE DR
WHITE PLAINS NY
10607-2726
US

V. Phone/Fax

Practice location:
  • Phone: 212-582-7117
  • Fax:
Mailing address:
  • Phone: 914-500-3397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF347723-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: