Provider Demographics
NPI:1548240435
Name:JAMES, CASSILDA (MD)
Entity Type:Individual
Prefix:
First Name:CASSILDA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MALTESE DRIVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940
Mailing Address - Country:US
Mailing Address - Phone:845-342-4774
Mailing Address - Fax:845-342-7022
Practice Address - Street 1:111 MALTESE DR
Practice Address - Street 2:SUITE 302
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2115
Practice Address - Country:US
Practice Address - Phone:845-342-4774
Practice Address - Fax:845-342-7022
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162262207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
66D292Medicare ID - Type Unspecified
B78834Medicare UPIN