Basic Information
Provider Information
NPI: 1912989492
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KASABIAN
FirstName: ROBERT
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 143 LONGWATER DR
Address2:  
City: NORWELL
State: MA
PostalCode: 020611683
CountryCode: US
TelephoneNumber: 7818785200
FaxNumber:  
Practice Location
Address1: 143 LONGWATER DR
Address2:  
City: NORWELL
State: MA
PostalCode: 020611683
CountryCode: US
TelephoneNumber: 7818785200
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/18/2005
LastUpdateDate: 01/08/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X38687MAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
04229784501MAHCVMOTHER
76543001MATUFTSOTHER
76543001MATUFTS MEDICARE PREFERREDOTHER
6225401MAHVD PILGRIM HEALTH CAREOTHER
04229784501MAUNITED HEALTH CAREOTHER
001642301MANEIGHBORHOOD HLTH PLANOTHER
04229784501MAGREAT WEST HEALTH CAREOTHER
04229784501 GIC UNICAREOTHER
B1035120101MACIGNAOTHER
04229784501MAPRIVATE HEALTHCARE SYSTEMOTHER
04229784501MATRICAREOTHER
204078605MA MEDICAID
3630601MAFALLONOTHER
J1802101MABCBSMAOTHER
04229784501MADOC FIRSTOTHER
421861601MAAETNAOTHER


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