Provider Demographics
NPI:1407995517
Name:CASSARI PAIN TREATMENT CENTER INC
Entity Type:Organization
Organization Name:CASSARI PAIN TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:CASSARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-891-8973
Mailing Address - Street 1:PO BOX 950232
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0232
Mailing Address - Country:US
Mailing Address - Phone:502-891-8973
Mailing Address - Fax:502-891-8975
Practice Address - Street 1:4010 DUPONT CIRCLE #430
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-891-8973
Practice Address - Fax:502-891-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22779208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty