Healthcare Provider Details

I. General information

NPI: 1700043346
Provider Name (Legal Business Name): JOSEPH ALBERT CASPERSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 RED LION RD
PHILADELPHIA PA
19114-1436
US

IV. Provider business mailing address

506 HARBOUR DR APT C3
BENSALEM PA
19020-7015
US

V. Phone/Fax

Practice location:
  • Phone: 215-612-4963
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOT011410
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: