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NPI Code Detail

MEDICARE: MS. ALEXIS PADOVANO CASAC

MEDICARE: MS. ALEXIS PADOVANO CASAC
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
1171M00000XCase Manager/Care Coordinator25704NY

General Provider Information

NPI Number : 1285062026
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALEXIS PADOVANO CASAC
Provider Business Mailing Address
First Line : 158 MCCLEAN AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-4651
Country : US
Telephone Number : 646-441-1917
Fax Number :
Provider Business Practice Location Address
First Line : 1915 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2127
Country : US
Telephone Number : 718-981-3136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2013
Last Update Date : 10/14/2013

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