Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MA43378 | NJ |
NPI | 1053398941 |
---|---|
Provider Name | Dr. Kathleen King Casey |
First Address | Freehold, NJ 07728-9049 |
Second Address | Neptune, NJ 07753-4488 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 03/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3386104 | (05) | NJ |
D06784 | (02) | NJ |