Provider Demographics
NPI:1811486368
Name:THOMAS J CASSIDY MD LLC
Entity type:Organization
Organization Name:THOMAS J CASSIDY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ANN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRANTE
Authorized Official - Suffix:
Authorized Official - Credentials:CMM
Authorized Official - Phone:732-767-3130
Mailing Address - Street 1:3910 PARK AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3062
Mailing Address - Country:US
Mailing Address - Phone:732-767-3130
Mailing Address - Fax:732-767-3134
Practice Address - Street 1:3910 PARK AVE STE 8
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3062
Practice Address - Country:US
Practice Address - Phone:732-767-3130
Practice Address - Fax:732-767-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty