MEDICARE: DR. KASTRIOT KACI GENERAL DENTIST

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	1223G0001X	General Practice Dentistry	056431-1	NY

General Provider Information

NPI Number	:	1902068844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KASTRIOT KACI GENERAL DENTIST

Provider Business Mailing Address
First Line	:	17 HILLBURN RD
Second Line	:
City	:	SCARSDALE
State	:	NY
Zip	:	10583-2719
Country	:	US
Telephone Number	:	352-246-3458
Fax Number	:

Provider Business Practice Location Address
First Line	:	2176 CENTRAL PARK AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10710-1826
Country	:	US
Telephone Number	:	914-337-2600
Fax Number	:

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

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	03/22/2013

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