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General NPI Number Information
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NPI Number | 1376914200
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Entity Type | Individual
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Provider Name | ELONA KASO DMD
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Gender | Female
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 101 CRAWFORDS CORNER RD STE 1110
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City | HOLMDEL
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State | NJ
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Zip | 07733-1977
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Country | US
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Telephone | 732-444-8822
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Fax | 732-314-0222
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Provider Business Mailing Address
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Address Line | 351 54TH ST FL2
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City | BROOKLYN
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State | NY
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Zip | 11220-3011
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Country | US
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Telephone | 347-768-9298
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02619100
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License Number State | NJ
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