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General NPI Number Information
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NPI Number | 1528027356
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Entity Type | Individual
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Provider Name | MOHAMED KASSEM M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 1300 MAIN AVE STE 2C
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City | CLIFTON
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State | NJ
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Zip | 07011-2266
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Country | US
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Telephone | 973-417-0181
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Fax |
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Provider Business Mailing Address
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Address Line | 46 OVERLOOK RDG
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City | OAKLAND
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State | NJ
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Zip | 07436-2361
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Country | US
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Telephone | 973-417-0181
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA10724300
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License Number State | NJ
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