Provider Demographics
NPI:1366958266
Name:KASSAI, NEDA
Entity type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:KASSAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 DONNA LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1211
Mailing Address - Country:US
Mailing Address - Phone:551-804-0230
Mailing Address - Fax:
Practice Address - Street 1:895 W BAY AVE
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-2121
Practice Address - Country:US
Practice Address - Phone:609-698-2329
Practice Address - Fax:609-698-2329
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03841000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist