Healthcare Provider Details

I. General information

NPI: 1265478440
Provider Name (Legal Business Name): BILAL AHMAD KASKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST
BRIGHTON MA
02135
US

IV. Provider business mailing address

28 SCHOFIELD DR
NEWTON MA
02460-1127
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-3000
  • Fax:
Mailing address:
  • Phone: 336-529-8923
  • Fax: 352-327-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number290753
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number290753
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: