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General NPI Number Information
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NPI Number | 1073573234
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Entity Type | Individual
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Provider Name | GERARD R CASSISTA B.S.,D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 1350 LAKEVIEW AVE
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City | DRACUT
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State | MA
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Zip | 01826-3497
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Country | US
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Telephone | 978-957-5585
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Fax | 978-957-8258
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Provider Business Mailing Address
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Address Line | 1350 LAKEVIEW AVE
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City | DRACUT
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State | MA
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Zip | 01826-3497
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Country | US
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Telephone | 978-957-5585
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Fax | 978-957-8258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 553
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License Number State | MA
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