Provider Demographics
NPI:1649731738
Name:APICELLA, CASSANDRA MARIA (DO)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MARIA
Last Name:APICELLA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 E 41ST ST FL 24
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:352-594-1926
Practice Address - Street 1:222 E 41ST ST FL 24
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6942
Practice Address - Country:US
Practice Address - Phone:212-263-7019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19872207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL118418600Medicaid