Provider Demographics
NPI:1952492928
Name:CASSATA, JOSEPH K (PT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:K
Last Name:CASSATA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 PARK CLUB LANE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5326
Mailing Address - Country:US
Mailing Address - Phone:716-632-9200
Mailing Address - Fax:
Practice Address - Street 1:192 PARK CLUB LANE
Practice Address - Street 2:SUITE 110
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5326
Practice Address - Country:US
Practice Address - Phone:716-632-9200
Practice Address - Fax:716-632-1730
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0201391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026866901OtherUNIVERA
NY000526839002OtherBC/BS
NY9311497OtherIHA/HMO
NY1931125OtherAETNA
NY000526839002OtherBC/BS
NY9311497OtherIHA/HMO