1437352838 NPI number — DR ARTHUR KASSIS

Table of content: (NPI 1437352838)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437352838 NPI number — DR ARTHUR KASSIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR ARTHUR KASSIS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437352838
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4430 EASTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18020-9758
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-868-1713
Provider Business Mailing Address Fax Number:
610-838-4279

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4430 EASTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18020-9758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-868-1713
Provider Business Practice Location Address Fax Number:
610-838-4279
Provider Enumeration Date:
06/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BACKENTSTOE
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
BILLING DEPT
Authorized Official Telephone Number:
610-751-1289

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC004022L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02787400 . This is a "AMERICAN HEALTH SPEC NET" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1589708 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1545837 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02787400 . This is a "CAPITAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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