Healthcare Provider Details
I. General information
NPI: 1508028515
Provider Name (Legal Business Name): CASSYANNE L AGUIAR LAPSIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/30/2008
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 CHILDRENS LN
NORFOLK VA
23507-1910
US
IV. Provider business mailing address
313 CONSERVATION XING
CHESAPEAKE VA
23320-7001
US
V. Phone/Fax
- Phone: 757-668-8572
- Fax: 757-668-7784
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 0101261191 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0216X |
| Taxonomy | Pediatric Rheumatology Physician |
| License Number | 0101261191 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: