Provider Demographics
NPI:1346290079
Name:KASHER, FANNY B (MD)
Entity Type:Individual
Prefix:DR
First Name:FANNY
Middle Name:B
Last Name:KASHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 MEISNER AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-1236
Mailing Address - Country:US
Mailing Address - Phone:718-864-7340
Mailing Address - Fax:
Practice Address - Street 1:11 RALPH PL
Practice Address - Street 2:SUITE 102
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4419
Practice Address - Country:US
Practice Address - Phone:718-273-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142529208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000880520Medicaid
NYB14270Medicare UPIN
NY40D931Medicare ID - Type Unspecified