MEDICARE: CASSANDRA HUNSBERGER FNP-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
1	363LF0000X	Family Nurse Practitioner	339774	NY

General Provider Information

NPI Number	:	1720455322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA HUNSBERGER FNP-C

Provider Business Mailing Address
First Line	:	3045 EAST AVE
Second Line	:
City	:	CENTRAL SQUARE
State	:	NY
Zip	:	13036-2611
Country	:	US
Telephone Number	:	315-668-1202
Fax Number	:

Provider Business Practice Location Address
First Line	:	3045 EAST AVE
Second Line	:
City	:	CENTRAL SQUARE
State	:	NY
Zip	:	13036-2611
Country	:	US
Telephone Number	:	315-668-1202
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	04/28/2016

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