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General NPI Number Information
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NPI Number | 1881587251
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Entity Type | Individual
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Provider Name | CASSANDRA JO THOMAS OD
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 385 BANGOR JUNCTION RD
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City | BANGOR
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State | PA
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Zip | 18013-9369
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Country | US
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Telephone | 570-810-5209
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Fax |
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Provider Business Mailing Address
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Address Line | 205 N 7TH ST
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City | BANGOR
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State | PA
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Zip | 18013-1734
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Country | US
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Telephone | 570-875-9758
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG004269
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License Number State | PA
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