MEDICARE: CASELLI AVENUE PROFESSIONALS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	27801	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060049547	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	WCSKQ	OTHER	AZ	SUN HEALTH GROUP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184091704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASELLI AVENUE PROFESSIONALS

Provider Business Mailing Address
First Line	:	9812 N 7TH ST
Second Line	:	9812 N 7TH STREET SUITE 7
City	:	PHOENIX
State	:	AZ
Zip	:	85020-1763
Country	:	US
Telephone Number	:	602-714-6783
Fax Number	:	602-325-0125

Provider Business Practice Location Address
First Line	:	9812 N 7TH ST
Second Line	:	9812 N 7TH STREET SUITE 7
City	:	PHOENIX
State	:	AZ
Zip	:	85020-1763
Country	:	US
Telephone Number	:	602-714-6783
Fax Number	:	602-325-0125

Authorized Official
Title or Position	:	CEO
Name	:	JOHN SUTHERLAND
Credential	:	M.D.
Telephone Number	:	602-714-6783

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	08/31/2015

Similar Medicare Providers

1447251848 — JOHN SUTHERLAND MD
Practice Location Address:

9812 N 7TH ST , SUITE 7
PHOENIX, AZ
85020-1763

Practice Phone: 602-714-6783
Practice Fax:

1558354985 — MRS. PATRICIA LEE LEHEW DC
Practice Location Address:

9812 N 7TH ST , SUITE #6
PHOENIX, AZ
85020-1763

Practice Phone: 602-870-1876
Practice Fax: 602-997-2291

1669845558 — CASELLI AVENUE PROFESSIONALS LLC
Practice Location Address:

9812 N 7TH ST , 9812 N. 7TH STREET
PHOENIX, AZ
85020-1763

Practice Phone: 602-714-6783
Practice Fax: 602-325-0125

1700903390 — DANIEL THOMAS WISE D.C.
Practice Location Address:

14307 JARRETTSVILLE PIKE
PHOENIX, MD
21131-1763

Practice Phone: 410-592-7300
Practice Fax: 410-666-0348

1811191760 — DR. SCOTT GREGORY STRATMANN D.C.
Practice Location Address:

6025 N 27TH AVE , SUITE 16
PHOENIX, AZ
85017-1763

Practice Phone: 602-242-2050
Practice Fax: 602-242-1564

1649448374 — JCC LLC
Practice Location Address:

14307 JARRETTSVILLE PIKE
PHOENIX, MD
21131-1763

Practice Phone: 410-592-7300
Practice Fax: 410-666-0348

Directions to “CASELLI AVENUE PROFESSIONALS ” Practice Location

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