Provider Demographics
NPI:1457972713
Name:CASCIOLA, PHILIPPE
Entity Type:Individual
Prefix:
First Name:PHILIPPE
Middle Name:
Last Name:CASCIOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 CHELTENHAM ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7220
Mailing Address - Country:US
Mailing Address - Phone:917-971-8025
Mailing Address - Fax:
Practice Address - Street 1:3215 CHELTENHAM ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7220
Practice Address - Country:US
Practice Address - Phone:917-971-8025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20201750058253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care