Provider Demographics
NPI:1184663189
Name:KASSIRER, JEROME P (MD)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:P
Last Name:KASSIRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SQUIRREL RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-3116
Mailing Address - Country:US
Mailing Address - Phone:781-237-1971
Mailing Address - Fax:
Practice Address - Street 1:21 SQUIRREL RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-3116
Practice Address - Country:US
Practice Address - Phone:781-237-1971
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine