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Individual

RICHARD KASULKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 NORTH ST, SUITE 101, GENEVA, NY 14456-1561
(315) 787-5100
(315) 787-5108
Mailing address
200 NORTH ST, SUITE 101, GENEVA, NY 14456-1561
(315) 787-5100
(315) 787-5108

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
139140
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1221934FZ
PREFERRED CARE
NY
01
61640335
GHI
NY
05
66519
NY
01
P010139140
BLUE SHIELD
NY
Enumeration date
10/24/2006
Last updated
06/28/2010
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