Basic Information
| Provider Information | |||||||||
| NPI: | 1871586446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARCHER | ||||||||
| FirstName: | CASSANDRA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 161 GENESEE ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | AUBURN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130212662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152550947 | ||||||||
| FaxNumber: | 3152550942 | ||||||||
| Practice Location | |||||||||
| Address1: | 161 GENESEE ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | AUBURN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130212662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152550947 | ||||||||
| FaxNumber: | 3152550942 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2005 | ||||||||
| LastUpdateDate: | 10/23/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 236308 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 236308 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.