Basic Information
| Provider Information | |||||||||
| NPI: | 1386090330 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ISRAEL | ||||||||
| FirstName: | CASSANDRA | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VAFLOR | ||||||||
| OtherFirstName: | CASSANDRA | ||||||||
| OtherMiddleName: | LOUISE | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 590 MANNING DR | ||||||||
| Address2: | CB# 7595 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275996119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199663456 | ||||||||
| FaxNumber: | 9199666125 | ||||||||
| Practice Location | |||||||||
| Address1: | 590 MANNING DR | ||||||||
| Address2: | CB# 7595 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275996119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199663456 | ||||||||
| FaxNumber: | 9199666125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2016 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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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 | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 218295 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.