Provider Demographics
NPI:1255038402
Name:PAWK, CASSANDRA
Entity type:Individual
Prefix:MISS
First Name:CASSANDRA
Middle Name:
Last Name:PAWK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4440
Mailing Address - Country:US
Mailing Address - Phone:973-433-5481
Mailing Address - Fax:
Practice Address - Street 1:2502 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4440
Practice Address - Country:US
Practice Address - Phone:973-433-5481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health