Provider Demographics
NPI:1043319833
Name:CASEY, LINDA SUSAN (RNNP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUSAN
Last Name:CASEY
Suffix:
Gender:F
Credentials:RNNP
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Other - Credentials:
Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2859
Mailing Address - Country:US
Mailing Address - Phone:315-701-2550
Mailing Address - Fax:315-701-2551
Practice Address - Street 1:739 IRVING AVE STE 600
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1663
Practice Address - Country:US
Practice Address - Phone:315-701-2550
Practice Address - Fax:315-701-2551
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF300245-1363LA2200X
NY364453-1163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400063572Medicare PIN