1265813208 NPI number — WHITNEY CASAZZA PT, DPT

Table of content: RICHARD C TIMMING MD (NPI 1336112184)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265813208 NPI number — WHITNEY CASAZZA PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASAZZA
Provider First Name:
WHITNEY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EAKIN
Provider Other First Name:
WHITNEY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265813208
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
442 ARAGONA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VINTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24179-2804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-991-0900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10518 SPOTSYLVANIA AVE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22408-2693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-873-2302
Provider Business Practice Location Address Fax Number:
540-710-5341
Provider Enumeration Date:
06/16/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305209475 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2305209475 . This is a "PHYSICAL THERAPY LICENSE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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