Healthcare Provider Details

I. General information

NPI: 1548240435
Provider Name (Legal Business Name): CASSILDA JAMES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MALTESE DR SUITE 302
MIDDLETOWN NY
10940-2115
US

IV. Provider business mailing address

111 MALTESE DRIVE SUITE 302
MIDDLETOWN NY
10940
US

V. Phone/Fax

Practice location:
  • Phone: 845-342-4774
  • Fax: 845-342-7022
Mailing address:
  • Phone: 845-342-4774
  • Fax: 845-342-7022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number162262
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: