Healthcare Provider Details

I. General information

NPI: 1699877209
Provider Name (Legal Business Name): DEBORAH L CASSON NPP CS MS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KEUKA BUSINESS PARK
PENN YAN NY
14527
US

IV. Provider business mailing address

2075 SCOTTSVILLE RD
ROCHESTER NY
14623-2021
US

V. Phone/Fax

Practice location:
  • Phone: 315-536-6913
  • Fax: 315-536-7258
Mailing address:
  • Phone: 315-536-6913
  • Fax: 315-536-7258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400234-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: