Provider Demographics
NPI:1033311121
Name:CASSESE, TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:CASSESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MOUNT CARMEL AVENUE
Mailing Address - Street 2:FRANK NETTER SCHOOL OF MEDICINE
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-582-3544
Mailing Address - Fax:203-582-1418
Practice Address - Street 1:275 MOUNT CARMEL AVENUE
Practice Address - Street 2:FRANK NETTER SCHOOL OF MEDICINE
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-582-3544
Practice Address - Fax:203-582-1418
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049028202C00000X, 207R00000X, 208M00000X
PAMD437241207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA824305OtherB/S AA #
PA037276OtherMLHC MEDICARE AA #
PA824305OtherB/S AA #