Provider Demographics
NPI:1528115078
Name:CASAS, LUIS F (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:F
Last Name:CASAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 FRANKLIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1227
Mailing Address - Country:US
Mailing Address - Phone:516-354-2121
Mailing Address - Fax:516-616-1127
Practice Address - Street 1:395 FRANKLIN AVENUE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1227
Practice Address - Country:US
Practice Address - Phone:516-354-2121
Practice Address - Fax:516-616-1127
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126430208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00248068Medicaid
NY00248068Medicaid
NY390351Medicare ID - Type Unspecified