Healthcare Provider Details

I. General information

NPI: 1033311121
Provider Name (Legal Business Name): TODD CASSESE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 MOUNT CARMEL AVENUE FRANK NETTER SCHOOL OF MEDICINE
HAMDEN CT
06518
US

IV. Provider business mailing address

275 MOUNT CARMEL AVENUE FRANK NETTER SCHOOL OF MEDICINE
HAMDEN CT
06518
US

V. Phone/Fax

Practice location:
  • Phone: 203-582-3544
  • Fax: 203-582-1418
Mailing address:
  • Phone: 203-582-3544
  • Fax: 203-582-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number049028
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD437241
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number049028
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD437241
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number049028
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: