Healthcare Provider Details

I. General information

NPI: 1497543557
Provider Name (Legal Business Name): ALEXANDRA JOAN CASSEUS PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLARA MAASS DR
BELLEVILLE NJ
07109-3550
US

IV. Provider business mailing address

1 CLARA MAASS DR
BELLEVILLE NJ
07109-3550
US

V. Phone/Fax

Practice location:
  • Phone: 973-450-2000
  • Fax:
Mailing address:
  • Phone: 973-450-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA066566
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP01007400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: