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NPI Code Detail

MEDICARE: LAWRENCE CASSANO DPM

MEDICARE: LAWRENCE CASSANO DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristN004610NY

General Provider Information

NPI Number : 1043206055
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE CASSANO DPM
Provider Business Mailing Address
First Line : 1273 WILLIAM FLOYD PKWY
Second Line :
City : SHIRLEY
State : NY
Zip : 11967-1810
Country : US
Telephone Number : 631-447-9263
Fax Number : 631-758-1904
Provider Business Practice Location Address
First Line : 1273 WILLIAM FLOYD PKWY
Second Line :
City : SHIRLEY
State : NY
Zip : 11967-1810
Country : US
Telephone Number : 631-447-9263
Fax Number : 631-758-1904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 11/04/2014

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Directions to “ LAWRENCE CASSANO DPM” Practice Location

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