# KAZUHIRO HISAMOTO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639414550
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 284767 | NY | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 284767 | NY | Yes |
| 363AM0700X | Medical Physician Assistant | 284767 | NY | — |

## Other

- **Enumeration date:** 12/04/2012
- **Last updated:** 07/07/2023