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General NPI Number Information
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NPI Number | 1336128362
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Entity Type | Individual
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Provider Name | ASHUTOSH KACKER MD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 1305 YORK AVE FL 5
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City | NEW YORK
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State | NY
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Zip | 10021-5663
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Country | US
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Telephone | 212-746-5097
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Fax | 212-746-8549
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Provider Business Mailing Address
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Address Line | BOX 29880 GPO
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City | NEW YORK
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State | NY
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Zip | 10087
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Country | US
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Telephone | 212-746-5097
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Fax | 212-746-8549
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 238264
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License Number State | NY
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