Provider Demographics
NPI:1235128497
Name:KASHKIN, JAY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:MICHAEL
Last Name:KASHKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23-00 ROUTE 208 SOUTH
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1559
Mailing Address - Country:US
Mailing Address - Phone:201-794-7400
Mailing Address - Fax:201-475-9669
Practice Address - Street 1:23-00 ROUTE 208 SOUTH
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1559
Practice Address - Country:US
Practice Address - Phone:201-794-7400
Practice Address - Fax:201-475-9669
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51994207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ136271Medicare ID - Type Unspecified
NJE13159Medicare UPIN