| Knm Enterprises Llc | |
|
191 Main St Old Saybrook CT 06475-2392 | |
| (860) 882-8614 | |
| Not Available |
| Full Name | Knm Enterprises Llc |
|---|---|
| Speciality | Social Worker |
| Location | 191 Main St, Old Saybrook, Connecticut |
| Authorized Official Name and Position | Katherine Kassler (MEMBER) |
| Authorized Official Contact | 8608828614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Knm Enterprises Llc Po Box 284 Colchester CT 06415-0284 Ph: (860) 882-8614 | Knm Enterprises Llc 191 Main St Old Saybrook CT 06475-2392 Ph: (860) 882-8614 |
| NPI Number | 1336629880 |
|---|---|
| Provider Enumeration Date | 08/15/2018 |
| Last Update Date | 08/15/2018 |
| Medicare PECOS PAC ID | 5092069864 |
|---|---|
| Medicare Enrollment ID | O20181114000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336629880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 7927 (Connecticut) | Primary |
| Provider Name | Katherine Victoria Kassler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386910727 PECOS PAC ID: 0244491298 Enrollment ID: I20120418000436 |
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