Kassnove, Matthew

Kassnove, Matthew is an sole proprietor health care provider with primary practice located at 440 Waverly Ave Ste 3 Suite 3, Patchogue NY 11772-1597. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Kassnove, Matthew can be contacted via phone (631) 654-3838.

Contact Information

Primary practice address
440 Waverly Ave Ste 3 Suite 3 Patchogue NY 11772-1597
Phone: (631) 654-3838
Fax: (631) 654-3832
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X N005591 New York

Profile Details

NPI number 1346226909
LBN Legal business name Kassnove, Matthew
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2005
Last updated Jan 8th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346226909 NPPES
New York MEDICAID 02354814-5

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