MEDICARE: DR. BARRY KWASMAN DPM

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	213E00000X	Podiatrist	P0857	FL
2	213E00000X	Podiatrist	N2612	NY

General Provider Information

NPI Number	:	1174502405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY KWASMAN DPM

Provider Business Mailing Address
First Line	:	9101 TREMEZZO LN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-2747
Country	:	US
Telephone Number	:	561-452-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9101 TREMEZZO LN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-2747
Country	:	US
Telephone Number	:	561-452-7000
Fax Number	:

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

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	08/13/2007

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