Provider Demographics
NPI:1447702436
Name:CASEY, MONTANNA (ATC/L)
Entity type:Individual
Prefix:
First Name:MONTANNA
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HOMER ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2907
Mailing Address - Country:US
Mailing Address - Phone:203-856-3709
Mailing Address - Fax:
Practice Address - Street 1:125 ROUTE 340
Practice Address - Street 2:
Practice Address - City:SPARKILL
Practice Address - State:NY
Practice Address - Zip Code:10976-1041
Practice Address - Country:US
Practice Address - Phone:203-856-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer