Healthcare Provider Details

I. General information

NPI: 1295949741
Provider Name (Legal Business Name): GEORGES JEAN CASIMIR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 12/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ANDOVER RD
ROCKVILLE CENTRE NY
11570-1519
US

IV. Provider business mailing address

4 ANDOVER RD
ROCKVILLE CENTRE NY
11570-1519
US

V. Phone/Fax

Practice location:
  • Phone: 917-687-5694
  • Fax:
Mailing address:
  • Phone: 917-687-5694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number157032
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number157032
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number157032
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number157032
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: