Provider Demographics
NPI:1508961939
Name:KASSAY, DAVID P (DC , CCSP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:KASSAY
Suffix:
Gender:M
Credentials:DC , CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SW PALM CITY RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2849
Mailing Address - Country:US
Mailing Address - Phone:772-286-8555
Mailing Address - Fax:772-286-8863
Practice Address - Street 1:1000 SW PALM CITY RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2849
Practice Address - Country:US
Practice Address - Phone:772-286-8555
Practice Address - Fax:772-286-8863
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6717111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU52969Medicare UPIN
FL55209Medicare ID - Type Unspecified