Provider Demographics
NPI:1841325958
Name:ALEXANDER KASATKIN M.D. P.C.
Entity type:Organization
Organization Name:ALEXANDER KASATKIN M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:E
Authorized Official - Last Name:KASATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-475-2225
Mailing Address - Street 1:28-02 FAIR LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3402
Mailing Address - Country:US
Mailing Address - Phone:201-475-2225
Mailing Address - Fax:201-475-2221
Practice Address - Street 1:28-02 FAIR LAWN AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3402
Practice Address - Country:US
Practice Address - Phone:201-475-2225
Practice Address - Fax:201-475-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ109897Medicare PIN
NJI53076Medicare UPIN
NYA100000207Medicare PIN