Healthcare Provider Details

I. General information

NPI: 1235751157
Provider Name (Legal Business Name): CASSANDRA JOY SOFFRON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 LAFAYETTE STREET ELLISON CAMPUS CENTER SUITE 107
SALEM MA
01970
US

IV. Provider business mailing address

352 LAFAYETTE ST
SALEM MA
01970-5348
US

V. Phone/Fax

Practice location:
  • Phone: 978-542-6413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN2334936
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2334936
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: