Provider Demographics
NPI:1629434857
Name:KASYAN, JOSEPH
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KASYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 FREDERICKA DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-3737
Mailing Address - Country:US
Mailing Address - Phone:412-736-7173
Mailing Address - Fax:412-854-0888
Practice Address - Street 1:120 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW EAGLE
Practice Address - State:PA
Practice Address - Zip Code:15067-1151
Practice Address - Country:US
Practice Address - Phone:724-258-3773
Practice Address - Fax:724-258-4805
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician