Provider Demographics
NPI:1033784608
Name:FAIRMAN, CASSIDY JO
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:JO
Last Name:FAIRMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 STONEBRAKER RD
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-9277
Mailing Address - Country:US
Mailing Address - Phone:724-599-8944
Mailing Address - Fax:
Practice Address - Street 1:835 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3629
Practice Address - Country:US
Practice Address - Phone:724-357-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant