Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MA064450 | NJ |
Y | 111NI0900X | Internist | MA064450 | NJ |
NPI | 1437247558 |
---|---|
Provider Name | Joseph Kasper |
First Address | Park Ridge, NJ 07656-0368 |
Second Address | Saddle River, NJ 07458-3057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |