Provider Demographics
NPI:1689773434
Name:KASSIRA, FIRAS PETER (OD)
Entity Type:Individual
Prefix:DR
First Name:FIRAS
Middle Name:PETER
Last Name:KASSIRA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WILTSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1517
Mailing Address - Country:US
Mailing Address - Phone:508-906-6006
Mailing Address - Fax:
Practice Address - Street 1:1099 PLEASANT ST STE B
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602
Practice Address - Country:US
Practice Address - Phone:508-906-6006
Practice Address - Fax:508-906-6006
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3568152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110019857AMedicaid
MA110019857AMedicaid