MEDICARE: AARON KASSOFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	097181	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073505665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON KASSOFF MD

Provider Business Mailing Address
First Line	:	63 SHAKER RD
Second Line	:	SUITE 101
City	:	ALBANY
State	:	NY
Zip	:	12204-1030
Country	:	US
Telephone Number	:	518-434-1042
Fax Number	:	518-434-4327

Provider Business Practice Location Address
First Line	:	63 SHAKER RD
Second Line	:	SUITE 101
City	:	ALBANY
State	:	NY
Zip	:	12204-1030
Country	:	US
Telephone Number	:	518-434-1042
Fax Number	:	518-434-4327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	03/04/2009

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