MEDICARE: MEGHAN M KASEL APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	26NJ00670200	NJ

General Provider Information

NPI Number	:	1295285914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN M KASEL APN

Provider Business Mailing Address
First Line	:	4 HARTFORD DR STE 1
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4945
Country	:	US
Telephone Number	:	732-559-1390
Fax Number	:	732-784-9170

Provider Business Practice Location Address
First Line	:	4 HARTFORD DR STE 1
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4945
Country	:	US
Telephone Number	:	732-741-3600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2016
Last Update Date	:	08/11/2020

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