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NPI Code Detail

MEDICARE: CASSANDRA LYNN BROOMELL PA-C

MEDICARE: CASSANDRA LYNN BROOMELL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMA061281PA

General Provider Information

NPI Number : 1215441894
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA LYNN BROOMELL PA-C
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 1000 E MOUNTAIN DR
Second Line :
City : WILKES BARRE
State : PA
Zip : 18711-0027
Country : US
Telephone Number : 570-820-6113
Fax Number : 570-826-7698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2017
Last Update Date : 01/08/2026

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Directions to “ CASSANDRA LYNN BROOMELL PA-C” Practice Location

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