Healthcare Provider Details

I. General information

NPI: 1477578540
Provider Name (Legal Business Name): DENISE WINIFRED ANN CASEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX 777
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 777
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2981
  • Fax: 585-273-1039
Mailing address:
  • Phone: 585-275-2981
  • Fax: 585-273-1039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number235874
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: