Provider Demographics
NPI:1073518858
Name:KASS, HOWARD JEFFREY (OD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JEFFREY
Last Name:KASS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4081 ROUTE 31
Mailing Address - Street 2:SEARS OPTICAL
Mailing Address - City:CLAY
Mailing Address - State:NY
Mailing Address - Zip Code:13041-8785
Mailing Address - Country:US
Mailing Address - Phone:315-652-4825
Mailing Address - Fax:
Practice Address - Street 1:4081 ROUTE 31
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:CLAY
Practice Address - State:NY
Practice Address - Zip Code:13041-8785
Practice Address - Country:US
Practice Address - Phone:315-652-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV00003150152W00000X, 152WC0802X, 152WS0006X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
56616BMedicare PIN
T49198Medicare UPIN