Doctor Name: | DR. JUNE G KASMINOFF |
NPI Number: | 1154414530 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPM |
License Number: | N004947 |
Business Practice Address: | 666 Old Bethpage Rd Old Bethpage, NY - 118041219 |
Business Phone Number: | 5165864055 |
Business Fax Number: | |
Mailing Address: | 666 Old Bethpage Rd, OLD BETHPAGE |
State: | NY |
Postal Code: | 118041219 |
Phone Number: | 5165864055 |
Fax Number: | 5167774565 |
NPI Enumeration Date: | 09/30/2006 |
NPI Last Update Date: | 11/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | N004947 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |