Healthcare Provider Details

I. General information

NPI: 1063770394
Provider Name (Legal Business Name): DAVID LEOR KASHAN MD FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 BRYANT AVE FL 3
ROSLYN NY
11576-1158
US

IV. Provider business mailing address

55 BRYANT AVE FL 3
ROSLYN NY
11576-1158
US

V. Phone/Fax

Practice location:
  • Phone: 516-515-9267
  • Fax: 206-649-7195
Mailing address:
  • Phone: 516-515-9267
  • Fax: 206-649-7195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number280902
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number280902
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: