Healthcare Provider Details
I. General information
NPI: 1801505326
Provider Name (Legal Business Name): CASSIE CIUK
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/23/2022
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
307 GRAFTON ST
SHREWSBURY MA
01545-6236
US
IV. Provider business mailing address
307 GRAFTON ST
SHREWSBURY MA
01545-6236
US
V. Phone/Fax
- Phone: 508-841-5037
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 26539 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: