Provider Demographics
NPI:1902874902
Name:CASSONE, EUGENE F (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:F
Last Name:CASSONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 PLAZA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-6438
Mailing Address - Country:US
Mailing Address - Phone:518-562-7171
Mailing Address - Fax:518-562-7474
Practice Address - Street 1:77 PLAZA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6438
Practice Address - Country:US
Practice Address - Phone:518-825-4437
Practice Address - Fax:518-825-4435
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY177576207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01186938Medicaid
C29252Medicare UPIN
NY56733CMedicare ID - Type Unspecified