| Cassandra Wanzo Md Pc | |
|
602 Bombay Ln Roswell GA 30076-5828 | |
| (678) 566-1440 | |
| (678) 566-1442 |
| Full Name | Cassandra Wanzo Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 602 Bombay Ln, Roswell, Georgia |
| Authorized Official Name and Position | Cassandra L Wanzo (OWNER) |
| Authorized Official Contact | 6785661440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cassandra Wanzo Md Pc 602 Bombay Ln Roswell GA 30076-5828 Ph: (678) 566-1440 | Cassandra Wanzo Md Pc 602 Bombay Ln Roswell GA 30076-5828 Ph: (678) 566-1440 |
| NPI Number | 1912377433 |
|---|---|
| Provider Enumeration Date | 09/26/2015 |
| Last Update Date | 09/26/2015 |
| Medicare PECOS PAC ID | 2365750569 |
|---|---|
| Medicare Enrollment ID | O20151008001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912377433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 35165 (Georgia) | Primary |
| Provider Name | Cassandra L Wanzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518914217 PECOS PAC ID: 2769409127 Enrollment ID: I20051026000161 |
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