Provider Demographics
NPI:1326133513
Name:CASS, ROGER M (MD PC FACP FAAA FACR)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:M
Last Name:CASS
Suffix:
Gender:M
Credentials:MD PC FACP FAAA FACR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 MT HOPE AVE
Mailing Address - Street 2:STE 222
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620
Mailing Address - Country:US
Mailing Address - Phone:585-473-6785
Mailing Address - Fax:585-473-6802
Practice Address - Street 1:1351 MT HOPE AVE
Practice Address - Street 2:STE 222
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-473-6785
Practice Address - Fax:585-473-6802
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYABIM542207K00000X
NY086812207R00000X
NYCER26234207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
13266BMedicare ID - Type Unspecified
B72023Medicare UPIN