1629079934 NPI number — DORIS M CASCINO MD

Table of content: DORIS M CASCINO MD (NPI 1629079934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629079934 NPI number — DORIS M CASCINO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASCINO
Provider First Name:
DORIS
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629079934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 N 20TH ST STE 301
Provider Second Line Business Mailing Address:
CHCA
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19103-1454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-567-2422
Provider Business Mailing Address Fax Number:
215-561-0959

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 E MARSHALL ST
Provider Second Line Business Practice Location Address:
CHESTER COUNTY HOSPITAL
Provider Business Practice Location Address City Name:
WEST CHESTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19380-4412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-431-5376
Provider Business Practice Location Address Fax Number:
610-431-5527
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD 420903 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0019404020004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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