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Organization
MATTHEW KASSNOVE, DPM, PC
Active
Organization
MATTHEW KASSNOVE, DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW KASSNOVE DPM (PRESIDENT)
(631) 549-0955
Entity
Organization
Contact information
Practice address
62 GREEN ST, HUNTINGTON, NY 11743-6912
(631) 549-0955
(631) 424-1696
Mailing address
62 GREEN ST, HUNTINGTON, NY 11743-6912
(631) 549-0955
(631) 424-1696
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WZT9J1
MEDICARE PTAN
NY
Enumeration date
04/17/2008
Last updated
12/19/2012
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