Healthcare Provider Details

I. General information

NPI: 1538781984
Provider Name (Legal Business Name): ABIGAIL IRENE CASEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 02/12/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 S CHURCH ST STE 100
MT PLEASANT PA
15666-1702
US

IV. Provider business mailing address

508 SOUTH STREET SUITE 100
MT PLEASANT PA
15666-1702
US

V. Phone/Fax

Practice location:
  • Phone: 724-547-4536
  • Fax: 724-547-3799
Mailing address:
  • Phone: 724-547-4536
  • Fax: 724-547-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT020064
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: