Provider Demographics
NPI:1205011459
Name:KASSAY, SCOTT A (RPH)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:A
Last Name:KASSAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 PORTAGE RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1120
Mailing Address - Country:US
Mailing Address - Phone:716-285-0514
Mailing Address - Fax:716-284-8418
Practice Address - Street 1:1020 PORTAGE RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1120
Practice Address - Country:US
Practice Address - Phone:716-285-0514
Practice Address - Fax:716-284-8418
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist