Provider Demographics
NPI:1902422256
Name:BARBARA, CASSONDRA LEIGH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CASSONDRA
Middle Name:LEIGH
Last Name:BARBARA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7224 WINBERT DR
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1449
Mailing Address - Country:US
Mailing Address - Phone:716-238-5831
Mailing Address - Fax:
Practice Address - Street 1:1751 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14223-1211
Practice Address - Country:US
Practice Address - Phone:716-541-0234
Practice Address - Fax:716-249-3765
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily