Provider Demographics
NPI:1124209317
Name:CASSARO, LINDSAY JEAN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:JEAN
Last Name:CASSARO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:LINDSAY
Other - Middle Name:JEAN
Other - Last Name:STANDIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:601 VERSAILLES RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601
Mailing Address - Country:US
Mailing Address - Phone:502-695-3946
Mailing Address - Fax:502-695-3847
Practice Address - Street 1:601 VERSAILLES RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601
Practice Address - Country:US
Practice Address - Phone:502-695-3946
Practice Address - Fax:502-695-3847
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0627007Medicare PIN