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Individual

DR. JOHN KASSOTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
951 ROANOKE AVE, RIVERHEAD, NY 11901-2724
(631) 369-5005
(631) 369-4994
Mailing address
951 ROANOKE AVE, RIVERHEAD, NY 11901-2724
(631) 727-7773
(631) 727-7832

Taxonomy

Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
187961-01
NY
207RC0000X
Cardiovascular Disease Physician
187961-1
NY
207RC0000X
Cardiovascular Disease Physician
25MA07553100
NJ
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
187961-01
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01755384
NY
Enumeration date
09/12/2005
Last updated
04/07/2023
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