Provider Demographics
NPI:1679664882
Name:CASSCELLS ORTHOPAEDICS AND SPORTS MEDICINE, PA
Entity Type:Organization
Organization Name:CASSCELLS ORTHOPAEDICS AND SPORTS MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:GREENLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-832-6220
Mailing Address - Street 1:2600 GLASGOW AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4773
Mailing Address - Country:US
Mailing Address - Phone:302-832-6220
Mailing Address - Fax:302-832-6226
Practice Address - Street 1:2600 GLASGOW AVE.
Practice Address - Street 2:SUITE 104
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5703
Practice Address - Country:US
Practice Address - Phone:302-832-6220
Practice Address - Fax:302-832-6226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1679664882Medicaid
DE205178646OtherBC/BS OF DE
DE1679664882OtherUNITED HEALTHCARE
DE610983600OtherUS DEPT OF LABOR
DE7922680OtherAETNA
2626449000OtherAMERI/KEYSTONE/PERSONAL C
DE2626449000OtherINDEPENDENCE BC/BS
DE7922680OtherAETNA
DE2626449000OtherINDEPENDENCE BC/BS
DE=========OtherDEVON INSURANCE
DE=========OtherCIGNA
DE205178646OtherBC/BS OF DE
DE205178646OtherBC/BS OF DE
DE=========OtherDEVON INSURANCE