Provider Demographics
NPI:1689397770
Name:CASSATA, LORENE HOOVER (FNP-C)
Entity Type:Individual
Prefix:
First Name:LORENE
Middle Name:HOOVER
Last Name:CASSATA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LORENE
Other - Middle Name:HOOVER
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:50 BRIANNA LN
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-9422
Mailing Address - Country:US
Mailing Address - Phone:315-730-8749
Mailing Address - Fax:
Practice Address - Street 1:3648 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-3024
Practice Address - Country:US
Practice Address - Phone:585-736-3503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily