MEDICARE: DR. SAMIR KASSICIEH DO

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
1	207Q00000X	Family Medicine Physician	A751	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A751	OTHER		NM STATE ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730254350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMIR KASSICIEH DO

Provider Business Mailing Address
First Line	:	PO BOX 12435
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87195-0435
Country	:	US
Telephone Number	:	505-877-0212
Fax Number	:	505-877-0139

Provider Business Practice Location Address
First Line	:	1010 BRIDGE BLVD SW STE A
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-3765
Country	:	US
Telephone Number	:	505-877-0212
Fax Number	:	505-877-0139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/01/2008

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1194715011 — DR. RAFAT M MANSOUR DDS
Practice Location Address:

1010 BRIDGE BLVD SW , SUITE E
ALBUQUERQUE, NM
87105-3765

Practice Phone: 505-877-0435
Practice Fax:

1447231261 — MR. IAN-MICHAEL ANTHONY LENTE PA-C
Practice Location Address:

1010 BRIDGE BLVD SW , SUITE B
ALBUQUERQUE, NM
87105-3765

Practice Phone: 505-508-1739
Practice Fax:

1336296805 — MAY PHARMACY ISLETA
Practice Location Address:

1010 BRIDGE BLVD SW
ALBUQUERQUE, NM
87105-3765

Practice Phone: 505-873-2377
Practice Fax: 505-255-6656

1366561060 — DR. EMERSON VICUNA D.D.S.
Practice Location Address:

1010 BRIDGE BLVD SW , STE F
ALBUQUERQUE, NM
87105-3765

Practice Phone: 505-877-1113
Practice Fax: 505-877-1813

1437333424 — VALLEY HEALTH CARE INC.
Practice Location Address:

1010 BRIDGE BLVD SW
ALBUQUERQUE, NM
87105-3765

Practice Phone: 505-873-4258
Practice Fax: 505-873-4260

Directions to “ DR. SAMIR KASSICIEH DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.