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General NPI Number Information
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NPI Number | 1992032908
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Entity Type | Individual
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Provider Name | FLAVIO CASOY M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 928 BROADWAY SUITE 1100
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City | NEW YORK
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State | NY
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Zip | 10010-6008
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Country | US
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Telephone | 646-504-9104
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Fax | 646-219-8593
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Provider Business Mailing Address
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Address Line | 223 BEDFORD AVE PMB #801
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City | BROOKLYN
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State | NY
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Zip | 11211-5525
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Country | US
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Telephone | 646-504-9104
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A113066
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 269007
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License Number State | NY
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