Provider Demographics
NPI:1679009351
Name:CASSIDY, DEBORAH M (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:765 AMSTERDAM AVE APT 12G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5717
Mailing Address - Country:US
Mailing Address - Phone:610-209-6788
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:646-888-1934
Practice Address - Fax:929-321-7251
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY324177-01208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation