Provider Demographics
NPI:1417937251
Name:KAISER, BRENT AARON (DC)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:AARON
Last Name:KAISER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SHREWSBURY AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4165
Mailing Address - Country:US
Mailing Address - Phone:732-758-8200
Mailing Address - Fax:732-758-8250
Practice Address - Street 1:555 SHREWSBURY AVE
Practice Address - Street 2:SUITE E
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4165
Practice Address - Country:US
Practice Address - Phone:732-758-8200
Practice Address - Fax:732-758-8250
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00621500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086605Medicare PIN
NJ143360Medicare PIN