Provider Demographics
NPI:1508809401
Name:CASSARA, ERNEST (DC)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:
Last Name:CASSARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 COUNTRY FARMS RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:532 ROUTE 70 W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3505
Practice Address - Country:US
Practice Address - Phone:856-857-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00589000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1000639900Medicaid
NJ2261413000OtherAMERIHEALTH
NJ3626861OtherAETNA HMO
NJ7507271OtherAETNA PPO
NJ1033226OtherCIGNA
NJ2304271000OtherAMERIHEALTH HMO
NJ2261413000OtherAMERIHEALTH