Provider Demographics
NPI:1396740346
Name:CASALE, LINDA R (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:CASALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6016
Mailing Address - Country:US
Mailing Address - Phone:203-292-2000
Mailing Address - Fax:203-292-0832
Practice Address - Street 1:1305 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6016
Practice Address - Country:US
Practice Address - Phone:203-292-2000
Practice Address - Fax:203-292-0832
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033020207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001330208Medicaid
CT110004928Medicare ID - Type Unspecified
CT001330208Medicaid