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NPI Code Detail

MEDICARE: CASSANDRA VIVEEN

MEDICARE: CASSANDRA VIVEEN
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 Assistant50.009150RXOH

General Provider Information

NPI Number : 1821776337
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA VIVEEN
Provider Business Mailing Address
First Line : 2500 METROHEALTH DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1900
Country : US
Telephone Number : 216-696-3876
Fax Number :
Provider Business Practice Location Address
First Line : 2500 METROHEALTH DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1900
Country : US
Telephone Number : 216-969-3876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2023
Last Update Date : 12/01/2025

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Directions to “ CASSANDRA VIVEEN ” Practice Location

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