Provider Demographics
NPI:1316292543
Name:KASHYAP, ADITYA A
Entity type:Individual
Prefix:DR
First Name:ADITYA
Middle Name:A
Last Name:KASHYAP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HOLYOKE ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2709
Mailing Address - Country:US
Mailing Address - Phone:413-538-7400
Mailing Address - Fax:
Practice Address - Street 1:50 HOLYOKE ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2709
Practice Address - Country:US
Practice Address - Phone:413-538-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18560811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice