Koth Michael Cassavaugh, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

046277 Issued in NY

Practice address

17 Lansing St
Auburn, NY 13021-1983

Phone

(315) 255-7296

Fax

(315) 255-7307

NPI assigned

Jul 30, 2012

Last updated

Sep 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1164778015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-8061",
            "fax_number": "315-470-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7296",
            "fax_number": "315-255-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSAVAUGH",
        "first_name": "KOTH",
        "middle_name": "MICHAEL",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "046277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Renee Carnicelli, LPN
• Lisa Marie Carnicelli, LMHC
• Kali Carpenter, LMSW
• Theresa Anne Casper-Klock, DDS
• Gina Marie Cassavaugh
• David Brian Castle, R.PH.
• Lisa Margaret Caswell, COTA/L
• Jackie Catalfano
• Nicole Catalfano
• Kerrie Catalino-Carranti, LCSW

• Pharmacist in Auburn, NY
• Providers in Auburn, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.