Provider Demographics
NPI:1053544676
Name:KASSLER, RICHARD (MSPT, OCS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:KASSLER
Suffix:
Gender:M
Credentials:MSPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 CENTRAL PARK W APT 16K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-8211
Mailing Address - Country:US
Mailing Address - Phone:917-846-4712
Mailing Address - Fax:
Practice Address - Street 1:372 CENTRAL PARK W APT 16K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8211
Practice Address - Country:US
Practice Address - Phone:917-846-4712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018556-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic