Healthcare Provider Details

I. General information

NPI: 1609826429
Provider Name (Legal Business Name): GILBERT KASIRSKY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 W STREET RD
FEASTERVILLE TREVOSE PA
19053-7817
US

IV. Provider business mailing address

41 UNIVERSITY DR SUITE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 215-710-6490
  • Fax: 215-710-6492
Mailing address:
  • Phone: 215-710-5522
  • Fax: 215-710-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS003198L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: