Provider Demographics
NPI:1235908211
Name:SCHURR, CASSY L
Entity Type:Individual
Prefix:
First Name:CASSY
Middle Name:L
Last Name:SCHURR
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 1:2923 RIVER RD APT 3
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1068
Mailing Address - Country:US
Mailing Address - Phone:716-258-9464
Mailing Address - Fax:
Practice Address - Street 1:2923 RIVER RD APT 3
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1068
Practice Address - Country:US
Practice Address - Phone:716-258-9464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY357654682172A00000X
NY579459353172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver