Provider Demographics
NPI:1194088542
Name:CASSUTO, STEVE (MS)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:CASSUTO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2714
Mailing Address - Country:US
Mailing Address - Phone:516-485-9532
Mailing Address - Fax:
Practice Address - Street 1:288 CEDAR LN
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2714
Practice Address - Country:US
Practice Address - Phone:516-485-9532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16343174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist