Provider Demographics
NPI:1093082208
Name:CASSEUS, LYDIA (RN)
Entity type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:
Last Name:CASSEUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:13 PARK CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2945
Mailing Address - Country:US
Mailing Address - Phone:845-479-9190
Mailing Address - Fax:
Practice Address - Street 1:2834 ROUTE 17M
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:10958-5011
Practice Address - Country:US
Practice Address - Phone:845-374-8700
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY641721163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse