Provider Demographics
NPI:1306230503
Name:KASAGO, ISRAEL
Entity Type:Individual
Prefix:
First Name:ISRAEL
Middle Name:
Last Name:KASAGO
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 1:1355 RIVER BEND DR
Mailing Address - Street 2:DEPT. OF PATHOLOGY AND LABORATORY MEDICINE
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3412
Mailing Address - Country:US
Mailing Address - Phone:561-626-5512
Mailing Address - Fax:
Practice Address - Street 1:1314 N MACOMB ST DEPT OF
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3131
Practice Address - Country:US
Practice Address - Phone:734-242-6872
Practice Address - Fax:734-242-4962
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301508647207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology