Provider Demographics
NPI:1497147938
Name:CASSINI, VINCENT
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:CASSINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2132
Mailing Address - Country:US
Mailing Address - Phone:732-449-7028
Mailing Address - Fax:
Practice Address - Street 1:306 RIVER AVE
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-2132
Practice Address - Country:US
Practice Address - Phone:732-449-7028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM28RI01422300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist