Healthcare Provider Details

I. General information

NPI: 1730325424
Provider Name (Legal Business Name): JENNY L CASCIO REGISTERED NURSE PSYCHIATRIC NURSE PRACTITIONER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2008
Last Update Date: 09/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 LINWOOD AVE
WILLIAMSVILLE NY
14221-6501
US

IV. Provider business mailing address

40 DAISY LN
AMHERST NY
14228-1263
US

V. Phone/Fax

Practice location:
  • Phone: 716-626-9016
  • Fax: 716-626-4271
Mailing address:
  • Phone: 716-316-3621
  • Fax: 716-626-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberF401150-1
License Number StateNY

VIII. Authorized Official

Name: JENNY L CASCIO
Title or Position: PRESIDENT
Credential: PMHNP-BC
Phone: 716-316-3621