MEDICARE: CASSANDRA JO THOMAS OD

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	152W00000X	Optometrist	OEG004269	PA

General Provider Information

NPI Number	:	1881587251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA JO THOMAS OD

Provider Business Mailing Address
First Line	:	205 N 7TH ST
Second Line	:
City	:	BANGOR
State	:	PA
Zip	:	18013-1734
Country	:	US
Telephone Number	:	570-875-9758
Fax Number	:

Provider Business Practice Location Address
First Line	:	385 BANGOR JUNCTION RD
Second Line	:
City	:	BANGOR
State	:	PA
Zip	:	18013-9369
Country	:	US
Telephone Number	:	570-810-5209
Fax Number	:

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	08/06/2025

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