Provider Demographics
NPI:1154353530
Name:CASEY, JENNIFER M (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:CASEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 WASHINGTON ST STE 321
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3889
Mailing Address - Country:US
Mailing Address - Phone:603-749-9900
Mailing Address - Fax:603-749-9901
Practice Address - Street 1:2 WASHINGTON ST STE 321
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3889
Practice Address - Country:US
Practice Address - Phone:603-749-9900
Practice Address - Fax:603-749-9901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH118982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE7310Medicare ID - Type Unspecified