Provider Demographics
NPI:1851331888
Name:DR. BRIAN KASHAN, D.P.M., PA
Entity Type:Organization
Organization Name:DR. BRIAN KASHAN, D.P.M., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-764-7044
Mailing Address - Street 1:6506 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2304
Mailing Address - Country:US
Mailing Address - Phone:410-764-7044
Mailing Address - Fax:410-764-8637
Practice Address - Street 1:6506 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2304
Practice Address - Country:US
Practice Address - Phone:410-764-7044
Practice Address - Fax:410-764-8637
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. BRIAN KASHAN, D.P.M., PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-07
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403742100Medicaid
1159030001Medicare NSC