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General NPI Number Information
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NPI Number | 1215016183
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Entity Type | Individual
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Provider Name | CASSANDRA LYNN TRIMARCO RPA-C
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Gender | Female
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 190 E JERICHO TPKE 2ND FLOOR
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City | MINEOLA
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State | NY
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Zip | 11501-2033
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Country | US
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Telephone | 516-977-9922
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Fax | 516-977-9926
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Provider Business Mailing Address
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Address Line | 25432 84TH DR
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City | FLORAL PARK
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State | NY
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Zip | 11001-1010
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Country | US
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Telephone | 718-343-5117
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Fax | 516-977-9926
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 10748
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License Number State | NY
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