Provider Demographics
NPI:1689924375
Name:SCHRADER, KASMINTAN ALEXANDRA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:KASMINTAN
Middle Name:ALEXANDRA
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 E 72ND ST APT 23A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-9802
Mailing Address - Country:US
Mailing Address - Phone:917-855-3490
Mailing Address - Fax:
Practice Address - Street 1:524 E 72ND ST APT 23A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-9802
Practice Address - Country:US
Practice Address - Phone:917-855-3490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP83216207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)