Provider Demographics
NPI:1780094243
Name:CASSIN, JARED
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:CASSIN
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 1:5 BUCKNAM RD STE 2C
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1209
Mailing Address - Country:US
Mailing Address - Phone:207-781-1500
Mailing Address - Fax:
Practice Address - Street 1:5 BUCKNAM RD STE 2C
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1209
Practice Address - Country:US
Practice Address - Phone:207-781-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD21607207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine