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NPI Code Detail

MEDICARE: JOHN KASZA R.D.

MEDICARE: JOHN KASZA R.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1588054456
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN KASZA R.D.
Provider Business Mailing Address
First Line : 909 JIBE RD APT E
Second Line :
City : NORTON SHORES
State : MI
Zip : 49441-6533
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2201 S GETTY ST
Second Line :
City : MUSKEGON HEIGHTS
State : MI
Zip : 49444-1207
Country : US
Telephone Number : 231-739-9315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2015
Last Update Date : 01/30/2015

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