Provider Demographics
NPI:1306888912
Name:CASELLA, FRANK JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:JOSEPH
Last Name:CASELLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:JOSEPH
Other - Last Name:CASELLA
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:532 LAFAYETTE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-4411
Mailing Address - Country:US
Mailing Address - Phone:973-940-0423
Mailing Address - Fax:973-729-3454
Practice Address - Street 1:89 SPARTA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1777
Practice Address - Country:US
Practice Address - Phone:973-729-2121
Practice Address - Fax:973-729-3454
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB053986207RN0300X
NJ25MB05398600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6210201Medicaid
NJ6210201Medicaid
NJ146090Medicare PIN