Basic Information
Provider Information
NPI: 1902465032
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERRAGAMO
FirstName: CASSANDRA
MiddleName: ROSE
NamePrefix: MS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 143 LONGWATER DR # 201
Address2:  
City: NORWELL
State: MA
PostalCode: 020611683
CountryCode: US
TelephoneNumber: 7817924136
FaxNumber: 7818786750
Practice Location
Address1: 55 FOGG RD
Address2:  
City: WEYMOUTH
State: MA
PostalCode: 021902432
CountryCode: US
TelephoneNumber: 7816248000
FaxNumber: 7818786750
Other Information
ProviderEnumerationDate: 06/12/2019
LastUpdateDate: 07/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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