Provider Demographics
NPI:1801050026
Name:KASDON, EARL J (MD)
Entity type:Individual
Prefix:
First Name:EARL
Middle Name:J
Last Name:KASDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 ELIOT RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-1016
Mailing Address - Country:US
Mailing Address - Phone:617-267-6767
Mailing Address - Fax:
Practice Address - Street 1:OFFICE OF THE CHIEF MEDICAL EXAMINER
Practice Address - Street 2:720 ALBANY STREET
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-267-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28405207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology