Provider Demographics
NPI:1780986430
Name:CASSALMAN, CHRISTA LYN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:LYN
Last Name:CASSALMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 PROSPECT ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4127
Mailing Address - Country:US
Mailing Address - Phone:617-852-5846
Mailing Address - Fax:
Practice Address - Street 1:85 PROSPECT ST UNIT 1
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4127
Practice Address - Country:US
Practice Address - Phone:617-852-5846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA284141207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology