Provider Demographics
NPI:1316923501
Name:CASH, MARY E (PA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:CASH
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:22 MASONIC AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3048
Mailing Address - Country:US
Mailing Address - Phone:203-679-5900
Mailing Address - Fax:203-265-7413
Practice Address - Street 1:22 MASONIC AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3048
Practice Address - Country:US
Practice Address - Phone:203-679-5900
Practice Address - Fax:203-265-7413
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2016-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT000596363A00000X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001005083Medicaid
S70374Medicare UPIN
CT970000300Medicare ID - Type Unspecified