Provider Demographics
NPI:1780562181
Name:JAQUISH, CASSANDRA T (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:T
Last Name:JAQUISH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:T
Other - Last Name:WARBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8531
Mailing Address - Country:US
Mailing Address - Phone:518-657-9374
Mailing Address - Fax:
Practice Address - Street 1:1 BELL TOWER DR
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189-2333
Practice Address - Country:US
Practice Address - Phone:518-268-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY356988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily