Provider Demographics
NPI:1285926170
Name:DELLA CASIMIR
Entity type:Organization
Organization Name:DELLA CASIMIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MISS
Authorized Official - First Name:DELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASIMIR
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:718-415-4701
Mailing Address - Street 1:1700 BEDFORD AVE
Mailing Address - Street 2:21-0
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-2667
Mailing Address - Country:US
Mailing Address - Phone:718-415-4701
Mailing Address - Fax:718-783-6799
Practice Address - Street 1:1700 BEDFORD AVE
Practice Address - Street 2:21-0
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-2667
Practice Address - Country:US
Practice Address - Phone:718-415-4701
Practice Address - Fax:717-783-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283647-1313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility