Provider Demographics
NPI:1093385544
Name:LEMANSKI, CASSIDY A
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:A
Last Name:LEMANSKI
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 1:22556 EDDY DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-3725
Mailing Address - Country:US
Mailing Address - Phone:586-201-7373
Mailing Address - Fax:
Practice Address - Street 1:22556 EDDY DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-3725
Practice Address - Country:US
Practice Address - Phone:586-201-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist