Provider Demographics
NPI:1285734525
Name:CASCARDO, NORA GAY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:NORA
Middle Name:GAY
Last Name:CASCARDO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MISS
Other - First Name:NORA
Other - Middle Name:GAY
Other - Last Name:MARCEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSCIAL THERAPIST
Mailing Address - Street 1:25525 HEREFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067
Mailing Address - Country:US
Mailing Address - Phone:248-544-6856
Mailing Address - Fax:248-538-5164
Practice Address - Street 1:33010 NORTHWESTERN HIGHWAY
Practice Address - Street 2:PREMIER THERAPY CENTERS, INC.
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322
Practice Address - Country:US
Practice Address - Phone:248-538-5165
Practice Address - Fax:248-538-5164
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010086812251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501008681OtherBLUE CROSS/BLUE SHIELD #
MIN83800001Medicare ID - Type UnspecifiedMEDICARE PART B NUMBER