Provider Demographics
NPI:1134164288
Name:CASSIN, MICHELE (OD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:CASSIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ORCHARD CIR
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1008
Mailing Address - Country:US
Mailing Address - Phone:978-263-8521
Mailing Address - Fax:978-263-7319
Practice Address - Street 1:296 GREAT RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4710
Practice Address - Country:US
Practice Address - Phone:978-263-8521
Practice Address - Fax:978-263-7319
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3441152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA730834OtherMEDICARE PREFERRED TUFTS
MA29788OtherFALLON
MA9169298OtherPHCS
MA5456578OtherFIRST HEALTH
MA152113OtherHPHC
MA2200495OtherUNITED HEALTHCARE
MA004563OtherNEIGHBORHOOD HEALTH
MA730834OtherTUFTS HEALTH
MAMA0021866OtherTRICARE
MA0393584Medicaid
MAW15978OtherBCBS
MA2200495OtherUNITED HEALTHCARE
MA5456578OtherFIRST HEALTH