Healthcare Provider Details

I. General information

NPI: 1942293626
Provider Name (Legal Business Name): LISA A CASLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NOYES ST
UTICA NY
13502-3854
US

IV. Provider business mailing address

32 HARTFORD TER
NEW HARTFORD NY
13413-2308
US

V. Phone/Fax

Practice location:
  • Phone: 315-738-3800
  • Fax: 315-738-4450
Mailing address:
  • Phone: 607-434-8409
  • Fax: 315-738-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number510913
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number400610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: