Provider Demographics
NPI:1225544950
Name:CASSARA CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:CASSARA CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-673-0411
Mailing Address - Street 1:191 COUNTRY FARMS RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1460
Mailing Address - Country:US
Mailing Address - Phone:856-857-0018
Mailing Address - Fax:856-857-0081
Practice Address - Street 1:532 ROUTE 70 W FL 1
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3505
Practice Address - Country:US
Practice Address - Phone:856-857-0018
Practice Address - Fax:856-857-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-18
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00589000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1033226OtherCIGNA
NJ3626861OtherAETNA HMO
NJ1000639900Medicaid
NJ2304271000OtherAMERIHEALTH HMO
NJ7507271OtherAETNA PPO