Provider Demographics
NPI:1851430250
Name:CASSARO, SEBASTIANO (MD)
Entity Type:Individual
Prefix:
First Name:SEBASTIANO
Middle Name:
Last Name:CASSARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5533 W HILLSDALE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5138
Mailing Address - Country:US
Mailing Address - Phone:959-622-8500
Mailing Address - Fax:
Practice Address - Street 1:5533 W HILLSDALE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5138
Practice Address - Country:US
Practice Address - Phone:959-622-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166974174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00984203Medicaid
NY133473533OtherEMPIRE PLAN
NY166974OtherHIP
NY-249466044OtherCIGNA
NY745267OtherUNITED HEALTHCARE
NY0C2770OtherHEALTH NET
NY137244OtherWELLCARE
NY160149OtherELDERPLAN
NYNS3932OtherOXFORD
NY0049179OtherGHI
NY81D421OtherEMPIRE BLUE CROSS BLUE SH
NY133473533Other1199 NATIONAL BENEFIT FUN
NY133473533OtherAETNA
NY745267OtherUNITED HEALTHCARE
NY166974OtherHIP