Provider Demographics
NPI:1225188063
Name:LOUIS J CASSANI
Entity Type:Organization
Organization Name:LOUIS J CASSANI
Other - Org Name:BARRE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:802-476-7932
Mailing Address - Street 1:341 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-4106
Mailing Address - Country:US
Mailing Address - Phone:802-476-7932
Mailing Address - Fax:802-479-5523
Practice Address - Street 1:341 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4106
Practice Address - Country:US
Practice Address - Phone:802-476-7932
Practice Address - Fax:802-479-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0280000071156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0007278Medicaid
VT0160480001Medicare ID - Type UnspecifiedOPTICIAN