MEDICARE: M J MELTZER & D G KASSAN MD LLP

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	207RG0100X	Gastroenterology Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1427155605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M J MELTZER & D G KASSAN MD LLP

Provider Business Mailing Address
First Line	:	70 GLEN COVE RD
Second Line	:	STE 306
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1726
Country	:	US
Telephone Number	:	516-621-7720
Fax Number	:	516-625-4521

Provider Business Practice Location Address
First Line	:	70 GLEN COVE RD
Second Line	:	STE 306
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1726
Country	:	US
Telephone Number	:	516-621-7720
Fax Number	:	516-625-4521

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. DANIEL GILEAD KASSAN
Credential	:	M.D.
Telephone Number	:	516-621-7720

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/30/2009

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