Provider Demographics
NPI:1912198920
Name:CASSON, ANNE R (PNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:R
Last Name:CASSON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 YORK AVE # PDH
Mailing Address - Street 2:MEMORIAL SLOAN KETTERING HOSP 9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:212-639-5948
Mailing Address - Fax:212-717-3107
Practice Address - Street 1:1275 YORK AVE # PDH
Practice Address - Street 2:MEMORIAL SLOAN KETTERING HOSP 9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-5948
Practice Address - Fax:212-717-3107
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381031363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics