Provider Demographics
NPI:1427002807
Name:CASSETTY, CHRISTOPHER TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:TODD
Last Name:CASSETTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1198
Mailing Address - Country:US
Mailing Address - Phone:908-782-1647
Mailing Address - Fax:908-782-7296
Practice Address - Street 1:6 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1198
Practice Address - Country:US
Practice Address - Phone:908-782-1647
Practice Address - Fax:908-782-7296
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07879800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
I23359Medicare UPIN