Provider Demographics
NPI:1598761025
Name:KASDAN, RICHARD BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRUCE
Last Name:KASDAN
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 1:5750 CENTRE AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3761
Mailing Address - Country:US
Mailing Address - Phone:412-361-4576
Mailing Address - Fax:412-361-1014
Practice Address - Street 1:5750 CENTRE AVE
Practice Address - Street 2:STE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3761
Practice Address - Country:US
Practice Address - Phone:412-361-4576
Practice Address - Fax:412-361-1014
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014409E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0725160Medicaid
PA0725160Medicaid
PAE63595Medicare UPIN