Provider Demographics
NPI:1356729412
Name:CASSINO, CARA (MD)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:CASSINO
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 1:333 E 46TH ST
Mailing Address - Street 2:APT 12D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-7401
Mailing Address - Country:US
Mailing Address - Phone:203-988-5778
Mailing Address - Fax:
Practice Address - Street 1:333 E 46TH ST
Practice Address - Street 2:12D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-7401
Practice Address - Country:US
Practice Address - Phone:203-988-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177078207RP1001X
CT040284207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF20999Medicare UPIN