Provider Demographics
NPI:1205842473
Name:KASPER, JOHN F (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:KASPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 594
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07822-0594
Mailing Address - Country:US
Mailing Address - Phone:609-957-5647
Mailing Address - Fax:609-957-5647
Practice Address - Street 1:6725 VENTNOR AVE
Practice Address - Street 2:SUITE A
Practice Address - City:VENTNOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08406-2152
Practice Address - Country:US
Practice Address - Phone:609-487-0100
Practice Address - Fax:609-487-0300
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB65614207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00068101OtherMEDICARE RAIL ROAD PIN
NJG57865Medicare UPIN
NJ901633Medicare PIN