Healthcare Provider Details

I. General information

NPI: 1972178945
Provider Name (Legal Business Name): DOV KASIRER MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2021
Last Update Date: 05/23/2021
Certification Date: 05/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 MCDONALD AVE
BROOKLYN NY
11223-1805
US

IV. Provider business mailing address

14711 76TH AVE APT 1A
FLUSHING NY
11367-3106
US

V. Phone/Fax

Practice location:
  • Phone: 718-787-1600
  • Fax:
Mailing address:
  • Phone: 646-315-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: