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General NPI Number Information
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NPI Number | 1902081342
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Entity Type | Organization
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Legal Business Name | LAWRENCE CASSANO
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 285 SILLS RD SUITE 10-A
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-4869
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Country | US
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Telephone | 631-447-9263
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Fax | 631-758-8249
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Provider Business Mailing Address
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Address Line | 285 SILLS RD SUITE 10-A
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-4869
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Country | US
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Telephone | 631-447-9263
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Fax | 631-758-1904
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAWRENCE CASSANO
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Credential | DPM
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Telephone | 631-447-9263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | N004610
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License Number State | NY
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