Provider Demographics
NPI:1407860976
Name:KASE, PETER (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:KASE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 DAVISON RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094
Mailing Address - Country:US
Mailing Address - Phone:716-433-9245
Mailing Address - Fax:716-433-3163
Practice Address - Street 1:828 DAVISON RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094
Practice Address - Country:US
Practice Address - Phone:716-433-9245
Practice Address - Fax:716-433-3163
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006457-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U11430Medicare UPIN
NYBA0556Medicare PIN