Provider Demographics
NPI:1639672835
Name:CASSATT, SARAH NICOLE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:CASSATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PERRY POINT VA MEDICAL CENTER , AVENUE D & 8TH ST
Mailing Address - Street 2:NUTRITION AND FOOD SERVICES BUILDING 17H
Mailing Address - City:PERRY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PERRY POINT VA MEDICAL CENTER AVENUE D & 8TH ST
Practice Address - Street 2:
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered