Most Relevant Information
Provider Data
| NPI Number: | 1003283771 |
| Provider Name: | CASSANDRA LYNN CONVERSE |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/28/2015 |
| Last Updated: | 08/28/2015 |
Provider Practice Location
175 FALMOUTH AVE
ELMWOOD PARK
NJ
074072312
Practice Location Phone/Fax
| Phone: | 2014142851 |
| Fax: |
Provider Mailing Location
175 FALMOUTH AVE
ELMWOOD PARK
NJ
074072312
Provider Mailing Phone/Fax
| Phone: | 2014142851 |
| Fax: |