Healthcare Provider Details

I. General information

NPI: 1619156940
Provider Name (Legal Business Name): MARIA ANNE KASDAN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 EXPRESS ST STE 400
PLAINVIEW NY
11803-2406
US

IV. Provider business mailing address

185 EXPRESS ST STE 400
PLAINVIEW NY
11803-2406
US

V. Phone/Fax

Practice location:
  • Phone: 516-777-8800
  • Fax: 516-777-8806
Mailing address:
  • Phone: 516-777-8800
  • Fax: 516-777-8806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number382023
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number537304
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: