Provider Demographics
NPI:1053959387
Name:LORMIL, CASSENDRA (APN)
Entity type:Individual
Prefix:
First Name:CASSENDRA
Middle Name:
Last Name:LORMIL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 CINDY ST
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1832
Mailing Address - Country:US
Mailing Address - Phone:862-224-0799
Mailing Address - Fax:
Practice Address - Street 1:3 HOSPITAL PLZ STE 208
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3084
Practice Address - Country:US
Practice Address - Phone:732-360-2700
Practice Address - Fax:732-360-2703
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00996300363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care