Basic Information
| Provider Information | |||||||||
| NPI: | 1891868857 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASSAR | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | RAYMOND | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1205 FRANKLIN AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115301600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162220067 | ||||||||
| FaxNumber: | 6312232271 | ||||||||
| Practice Location | |||||||||
| Address1: | 1205 FRANKLIN AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115301600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162220067 | ||||||||
| FaxNumber: | 6312232271 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 05/09/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 233299 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 233299 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.