Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 059053 | GA |
NPI | 1033144241 |
---|---|
Provider Name | Ezequiel Hernan Cassinelli |
First Address | Atlanta, GA 30309-1476 |
Second Address | Atlanta, GA 30342-1705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 22/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000503683 | ANTHEM (01) | |
0486290001 | DME (01) | |
203287 | UNISON (01) | |
2409521 | (05) | OH |
7848618 | AETNA (01) | |
H81499 | (02) | |
P00242139 | RAILROAD MEDICARE (01) | OH |
P00364266 | MCR RR (01) |