Provider Demographics
NPI:1699525642
Name:KASSEL, ZACHARY MYLES
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:MYLES
Last Name:KASSEL
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 1:38 RESTON RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3981
Mailing Address - Country:US
Mailing Address - Phone:973-832-6109
Mailing Address - Fax:
Practice Address - Street 1:38 RESTON RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3981
Practice Address - Country:US
Practice Address - Phone:973-832-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251X00000X
NJ347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No251X00000XAgenciesSupports Brokerage