Provider Demographics
NPI:1316309024
Name:CASSAGNOL, DAVID GERARD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GERARD
Last Name:CASSAGNOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:281 BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-2056
Mailing Address - Country:US
Mailing Address - Phone:646-596-7386
Mailing Address - Fax:646-850-9326
Practice Address - Street 1:281 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-2056
Practice Address - Country:US
Practice Address - Phone:646-596-7386
Practice Address - Fax:646-850-9326
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125075336207LP2900X
390200000X
NY310126207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program