MEDICARE: GARY DAVID KASSIMIR MSPT

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	222Z00000X	Orthotist	16224	MD
2	225100000X	Physical Therapist	16224	MD
3	2251H1200X	Hand Physical Therapist	16224	MD

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	:	1245210970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY DAVID KASSIMIR MSPT

Provider Business Mailing Address
First Line	:	2700 QUARRY LAKE DR STE 300
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-3746
Country	:	US
Telephone Number	:	410-377-8900
Fax Number	:	410-377-0576

Provider Business Practice Location Address
First Line	:	2700 QUARRY LAKE DR STE 300
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-3746
Country	:	US
Telephone Number	:	410-377-8900
Fax Number	:	410-377-0576

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	01/03/2025

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Directions to “ GARY DAVID KASSIMIR MSPT” Practice Location

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