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General NPI Number Information
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NPI Number | 1659501088
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Entity Type | Organization
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Legal Business Name | MICHAEL J KASSOUF, MD.,PC
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 346 76TH ST
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City | BROOKLYN
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State | NY
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Zip | 11209-3106
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Country | US
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Telephone | 718-238-0131
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Fax |
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Provider Business Mailing Address
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Address Line | 346 76TH ST
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City | BROOKLYN
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State | NY
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Zip | 11209-3106
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Country | US
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Telephone | 718-238-0131
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL J KASSOUF
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Credential | M.D.
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Telephone | 718-238-0131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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