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NPI Code Detail

MEDICARE: THEODORE ANDREW KASTNER M.D.,M.S.

MEDICARE: THEODORE ANDREW KASTNER M.D.,M.S.
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
1103TM1800XIntellectual & Developmental Disabilities PsychologistMA47761NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942226154
Entity Type Code : Individual
Provider Name (Legal Business Name) : THEODORE ANDREW KASTNER M.D.,M.S.
Provider Business Mailing Address
First Line : 1285 BROAD ST
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3045
Country : US
Telephone Number : 973-338-4200
Fax Number :
Provider Business Practice Location Address
First Line : 1285 BROAD ST
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3045
Country : US
Telephone Number : 973-338-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 04/30/2009

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