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General NPI Number Information
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NPI Number | 1952993289
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Entity Type | Individual
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Provider Name | CONOR VINCENT CASSARA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 94 MONTAUK HWY UNIT A
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City | EAST MORICHES
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State | NY
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Zip | 11940-1156
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Country | US
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Telephone | 631-874-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 73 JAGGER LN
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City | WESTHAMPTON
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State | NY
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Zip | 11977-1308
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Country | US
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Telephone | 631-903-4121
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 067621
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License Number State | NY
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