Provider Demographics
NPI:1508966771
Name:CASSANI, LOUIS JOSEPH (DO)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:JOSEPH
Last Name:CASSANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641
Mailing Address - Country:US
Mailing Address - Phone:802-476-7932
Mailing Address - Fax:802-479-5523
Practice Address - Street 1:341 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641
Practice Address - Country:US
Practice Address - Phone:802-476-7932
Practice Address - Fax:802-479-5523
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0280000071156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0007278Medicaid
VT0160480001Medicare ID - Type Unspecified