Provider Demographics
NPI:1881581478
Name:BAYNE, CASEY A (DPT)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:A
Last Name:BAYNE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 HAMILTON AVE APT 5B
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3539
Mailing Address - Country:US
Mailing Address - Phone:860-874-9128
Mailing Address - Fax:
Practice Address - Street 1:32 PHILIPS PKWY
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1811
Practice Address - Country:US
Practice Address - Phone:201-746-6577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist