Provider Demographics
NPI:1447301080
Name:DR HOWARD J KASS
Entity type:Organization
Organization Name:DR HOWARD J KASS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KASS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:315-434-9168
Mailing Address - Street 1:6438 BASILE ROWE
Mailing Address - Street 2:PO BOX 57
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-3900
Mailing Address - Country:US
Mailing Address - Phone:315-434-9168
Mailing Address - Fax:315-295-2522
Practice Address - Street 1:6438 BASILE ROWE
Practice Address - Street 2:BOX 57
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-3900
Practice Address - Country:US
Practice Address - Phone:315-434-9168
Practice Address - Fax:315-295-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003150152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56616BMedicare ID - Type Unspecified
NYT49198Medicare UPIN