Provider Demographics
NPI:1568615466
Name:CASSAGNOL, MARIE DANIELLE (REGSTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:DANIELLE
Last Name:CASSAGNOL
Suffix:
Gender:F
Credentials:REGSTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7202
Mailing Address - Country:US
Mailing Address - Phone:516-485-5249
Mailing Address - Fax:
Practice Address - Street 1:50 BROADWAY
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2519
Practice Address - Country:US
Practice Address - Phone:516-887-1200
Practice Address - Fax:516-593-2848
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600459-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse