Individual
THERESE P CASAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
135 KINNELON RD, SUITE 103, KINNELON, NJ 07405-2333
(973) 838-1771
(973) 492-2858
Mailing address
135 KINNELON RD, SUITE 103, KINNELON, NJ 07405-2333
(973) 838-1771
(973) 492-2858
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003705
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003705
STATE PA LICENSE NUMBER
GA
01
—
25MP00227500
STATE LICENSE
NJ
Enumeration date
08/30/2006
Last updated
04/29/2021
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