Provider Demographics
NPI:1982838959
Name:KASULE, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:KASULE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:KASULE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:158 CONCORD RD
Mailing Address - Street 2:D25
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-4609
Mailing Address - Country:US
Mailing Address - Phone:781-315-9380
Mailing Address - Fax:
Practice Address - Street 1:158 CONCORD RD
Practice Address - Street 2:D25
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-4609
Practice Address - Country:US
Practice Address - Phone:781-315-9380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59183164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse