Provider Demographics
NPI:1457670218
Name:CASSAGNOL, TRUCIA (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:TRUCIA
Middle Name:
Last Name:CASSAGNOL
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 EAST SUNRISE HWY
Mailing Address - Street 2:PO BOX 987
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5004
Mailing Address - Country:US
Mailing Address - Phone:516-536-5656
Mailing Address - Fax:516-536-3029
Practice Address - Street 1:355 W 52ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6239
Practice Address - Country:US
Practice Address - Phone:646-754-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6963241163W00000X
MA277655163W00000X
MACAS104385817363LW0102X
NYF4211981363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse