Provider Demographics
NPI:1346281961
Name:KASTER, BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:KASTER
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 1:77 CLIFTON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3111
Mailing Address - Country:US
Mailing Address - Phone:617-964-8200
Mailing Address - Fax:617-969-0996
Practice Address - Street 1:60 KENDRICK ST
Practice Address - Street 2:STE 204
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2726
Practice Address - Country:US
Practice Address - Phone:617-964-8200
Practice Address - Fax:617-969-0996
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA762712084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
J14770Medicare ID - Type Unspecified
MAF97272Medicare UPIN