Provider Demographics
NPI:1679703524
Name:BUCK, CASSANDRA L (MS, CGC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:L
Last Name:BUCK
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:J
Other - Last Name:LEDUC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:MGH REPRO ENDO, BHX-5
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-5526
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MGH REPRO ENDO, BHX-5
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-5526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2011-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS