Provider Demographics
NPI:1932534286
Name:CAO, CASSIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:
Last Name:CAO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:CAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:225 BROADWAY STE 2710
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3032
Mailing Address - Country:US
Mailing Address - Phone:646-875-8853
Mailing Address - Fax:855-300-2457
Practice Address - Street 1:225 BROADWAY STE 2710
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3032
Practice Address - Country:US
Practice Address - Phone:646-875-8853
Practice Address - Fax:855-300-2457
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1399193174400000X
NY001090-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist