Provider Demographics
NPI:1659453603
Name:KASPER, JENNIFER (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:KASPER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 EVERETT AVE
Mailing Address - Street 2:MGH CHELSEA HEALTHCARE CENTER
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-1807
Mailing Address - Country:US
Mailing Address - Phone:617-887-8300
Mailing Address - Fax:617-889-8571
Practice Address - Street 1:151 EVERETT AVE
Practice Address - Street 2:MGH CHELSEA HEALTHCARE CENTER
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-1807
Practice Address - Country:US
Practice Address - Phone:617-887-8300
Practice Address - Fax:617-889-8571
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80367208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ845381OtherAHCCCS
AZ845381Medicaid
MA80367OtherMEDICAL LICENSE
MA80367OtherMEDICAL LICENSE
MAA31611Medicare PIN
AZ845381OtherAHCCCS