Provider Demographics
NPI:1104478213
Name:CASCIATO, ALEXANDRA DIANNA
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:DIANNA
Last Name:CASCIATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 GOLF CLUB DR APT 3807
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5874
Mailing Address - Country:US
Mailing Address - Phone:856-430-3950
Mailing Address - Fax:
Practice Address - Street 1:392 S DONAHUE DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36849-5321
Practice Address - Country:US
Practice Address - Phone:856-430-3950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer