Provider Demographics
NPI:1871910117
Name:KASNI, RUDOLPH ROBERT JR (DDS BS)
Entity type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:ROBERT
Last Name:KASNI
Suffix:JR
Gender:M
Credentials:DDS BS
Other - Prefix:DR
Other - First Name:RUDY
Other - Middle Name:ROBERT
Other - Last Name:KASNI
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:200 CENTRAL PARK S
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1436
Mailing Address - Country:US
Mailing Address - Phone:212-935-5909
Mailing Address - Fax:
Practice Address - Street 1:200 CENTRAL PARK S
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1436
Practice Address - Country:US
Practice Address - Phone:212-935-5909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030787122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist