Healthcare Provider Details

I. General information

NPI: 1366837726
Provider Name (Legal Business Name): DAVID J KASPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 EAST ALLENDALE ROAD SUITE 3A
SADDLE RIVER NJ
07458
US

IV. Provider business mailing address

28 HERING RD
MONTVALE NJ
07645-1205
US

V. Phone/Fax

Practice location:
  • Phone: 201-825-3933
  • Fax:
Mailing address:
  • Phone: 201-925-9251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA11164800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: