Provider Demographics
NPI:1083478937
Name:KASOVICH, EDWARD M
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:M
Last Name:KASOVICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-6364
Mailing Address - Country:US
Mailing Address - Phone:724-570-7718
Mailing Address - Fax:
Practice Address - Street 1:318 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-6364
Practice Address - Country:US
Practice Address - Phone:724-570-7718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle