Provider Demographics
NPI:1356659122
Name:ERIK S. KASS, M.D., PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ERIK S. KASS, M.D., PROFESSIONAL CORPORATION
Other - Org Name:NATIONAL CAPITOL EAR, NOSE AND THROAT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:SERGE
Authorized Official - Last Name:KASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-778-3149
Mailing Address - Street 1:7986 OLD GEORGETOWN RD # B
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2458
Mailing Address - Country:US
Mailing Address - Phone:301-778-3149
Mailing Address - Fax:301-664-6470
Practice Address - Street 1:7986 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE B
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2458
Practice Address - Country:US
Practice Address - Phone:301-778-3149
Practice Address - Fax:301-664-6470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051250261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCI09630Medicare UPIN