Provider Demographics
NPI:1275623225
Name:CASCINO, VINCENT (OD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:CASCINO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 THEATRE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-2817
Mailing Address - Country:US
Mailing Address - Phone:814-269-3660
Mailing Address - Fax:814-269-2229
Practice Address - Street 1:410 THEATRE DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-2817
Practice Address - Country:US
Practice Address - Phone:814-269-3660
Practice Address - Fax:814-269-2229
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000618152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0545903Medicaid
PAT29539Medicare UPIN
PA0545903Medicaid