MEDICARE: BRUCE KASTER 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	2084P0805X	Geriatric Psychiatry Physician	76271	MA

General Provider Information

NPI Number	:	1346281961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE KASTER MD

Provider Business Mailing Address
First Line	:	77 CLIFTON RD
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02459-3111
Country	:	US
Telephone Number	:	617-964-8200
Fax Number	:	617-969-0996

Provider Business Practice Location Address
First Line	:	60 KENDRICK ST
Second Line	:	STE 204
City	:	NEEDHAM
State	:	MA
Zip	:	02494-2726
Country	:	US
Telephone Number	:	617-964-8200
Fax Number	:	617-969-0996

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	04/16/2019

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