Provider Demographics
NPI:1689059727
Name:LASHOMB, CASSANDRA LYNN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:LYNN
Last Name:LASHOMB
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:23 ROMODA DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1423
Mailing Address - Country:US
Mailing Address - Phone:800-285-1856
Mailing Address - Fax:
Practice Address - Street 1:ST LAWRENCE UNIVERSITY
Practice Address - Street 2:23 ROMODA DRIVE
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13662
Practice Address - Country:US
Practice Address - Phone:315-229-5392
Practice Address - Fax:315-229-5514
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY018735363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant