Provider Demographics
NPI:1528878550
Name:KRUE, CASSANDRA (PT, DPT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:KRUE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WATERFRONT DR
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-5048
Mailing Address - Country:US
Mailing Address - Phone:401-573-5222
Mailing Address - Fax:
Practice Address - Street 1:665 DYER AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6900
Practice Address - Country:US
Practice Address - Phone:401-942-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist