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Dr. John Kassotis

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NPI Number Detailed Information

Provider Information:

Name: Dr. John Kassotis
Gender: M
Provider License Number If Given: 187961-1

NPI Information:

NPI: 1598759003
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 10/29/2014

Provider Business Mailing Address:

Address: 450 CLARKSON AVE BOX 1262
Brooklyn, NY 11203
Phone Number: 7182708867
Fax Number: 7182701794

Provider Business Practice Location Address:

Address: 450 CLARKSON AVE 2ND FL. RM# A2-393
Brooklyn, NY 11203
Phone Number: 7182701081
Fax Number: 7182702917

Provider Taxonomy:

Primary: 207RC0000X
Secondary (if any):
State: NY

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