Provider Demographics
NPI:1154813947
Name:FERREIRA CASSINI, MARCELO (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MARCELO
Middle Name:
Last Name:FERREIRA CASSINI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LIND ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6502
Mailing Address - Country:US
Mailing Address - Phone:203-361-6630
Mailing Address - Fax:
Practice Address - Street 1:24 HOSPITAL AVE DEPT OF
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-739-7034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT73251207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY314682-1OtherNEW YORK STATE MEDICAL LICENSE
CT73251OtherSTATE OF CONNECTICUT - MEDICAL LICENSE