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General NPI Number Information
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NPI Number | 1437740800
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Entity Type | Individual
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Provider Name | CASSANDRA FORADORI PA
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Gender | Female
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 145 HOSPITAL AVE
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City | DU BOIS
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State | PA
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Zip | 15801-1462
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Country | US
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Telephone | 814-375-3750
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Fax |
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Provider Business Mailing Address
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Address Line | 753 WHETSTONE RD
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City | BROCKPORT
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State | PA
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Zip | 15823-1335
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Country | US
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Telephone | 814-591-4794
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA062325
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA005542
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License Number State | PA
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