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1770363210 NPI number — NIKEL AUSTELLY CASIMIR PA

NPI Number: 1770363210
Health Care Provider/Practitioner: NIKEL AUSTELLY CASIMIR PA

Information about “1770363210” NPI (NIKEL AUSTELLY CASIMIR PA) exists in 1770363210 in HTML format HTML  |  1770363210 in plain Text format TXT  |  1770363210 in PDF (Portable Document Format) PDF  |  1770363210 in an XML format XML  formats.

NPI Number : 1770363210 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770363210",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CASIMIR",
    "FirstName": "NIKEL",
    "MiddleName": "AUSTELLY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "133 PLEASANT ST APT 2",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH ANDOVER",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01845-2700",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "978-767-7612",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4374 EAST BUTTE AVENUE",
    "SecondLinePracticeLocationAddress": "EYMAN/ MEADOWNS UNIT",
    "PracticeLocationAddressCityName": "FLORENCE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85132",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "978-767-7612",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/03/2023",
    "LastUpdateDate": "03/18/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "9972",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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