Provider Demographics
NPI:1295812055
Name:KASINOF, STEVEN KERRY (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:KERRY
Last Name:KASINOF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19336 LEITERSBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742
Mailing Address - Country:US
Mailing Address - Phone:717-593-4521
Mailing Address - Fax:717-593-4525
Practice Address - Street 1:17301 VALLEY MALL ROAD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742
Practice Address - Country:US
Practice Address - Phone:301-582-1771
Practice Address - Fax:301-582-4681
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0610152W00000X
VA0618000615152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52626901OtherCAREFIRST BCBS
T21990Medicare UPIN
MD010M703EMedicare ID - Type Unspecified