Provider Demographics
NPI:1518920263
Name:CASCIERE, MICHAEL LANE (PT, MS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LANE
Last Name:CASCIERE
Suffix:
Gender:M
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 LENDEW ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7033
Mailing Address - Country:US
Mailing Address - Phone:336-275-7405
Mailing Address - Fax:336-275-3320
Practice Address - Street 1:1915 LENDEW ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7033
Practice Address - Country:US
Practice Address - Phone:336-275-7405
Practice Address - Fax:336-275-3320
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203776225100000X
NC1212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1649360686OtherANTHEM
NC4862886OtherAETNA
NC0787KOtherBCBS NC
NC650016635OtherMEDICARE RAILROAD
VAS83364Medicare UPIN
NC2503398Medicare PIN
NC0787KOtherBCBS NC
VA00V720C02Medicare PIN