Provider Demographics
NPI:1629272273
Name:WASSER, KERI N (MD)
Entity Type:Individual
Prefix:DR
First Name:KERI
Middle Name:N
Last Name:WASSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:103 PARK ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-5913
Mailing Address - Country:US
Mailing Address - Phone:973-902-8300
Mailing Address - Fax:973-783-9300
Practice Address - Street 1:103 PARK ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5913
Practice Address - Country:US
Practice Address - Phone:973-902-8300
Practice Address - Fax:973-783-9300
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2010-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA085664002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry