Provider Demographics
NPI:1679848378
Name:KASSEL, ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:KASSEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 466
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-0466
Mailing Address - Country:US
Mailing Address - Phone:860-693-6226
Mailing Address - Fax:860-693-8002
Practice Address - Street 1:65 ALBANY TPKE
Practice Address - Street 2:SUITE A
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2507
Practice Address - Country:US
Practice Address - Phone:860-693-6226
Practice Address - Fax:860-693-8002
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist