Provider Demographics
NPI:1356342828
Name:KASSOF, RONALD T (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:T
Last Name:KASSOF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10120 S EASTERN AVE
Mailing Address - Street 2:130
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052
Mailing Address - Country:US
Mailing Address - Phone:702-487-6880
Mailing Address - Fax:702-473-5455
Practice Address - Street 1:3153 E WARM SPRINGS 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:702-386-4700
Practice Address - Fax:702-386-4701
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175783207L00000X
NV13051207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1356342828Medicaid
NVVCY480ZMedicare PIN