Provider Demographics
NPI:1487629275
Name:CASSAGNOL, HANS P (MD)
Entity Type:Individual
Prefix:DR
First Name:HANS
Middle Name:P
Last Name:CASSAGNOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:736 IRVING AVE
Mailing Address - Street 2:SUITE 3657
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1687
Mailing Address - Country:US
Mailing Address - Phone:315-470-7903
Mailing Address - Fax:315-470-2838
Practice Address - Street 1:1000 E MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711-0027
Practice Address - Country:US
Practice Address - Phone:570-826-7914
Practice Address - Fax:570-820-6006
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2015-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD419675207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001915310Medicaid
H69758Medicare UPIN
PA061750Medicare ID - Type Unspecified