Provider Demographics
NPI:1699832956
Name:CASPER, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:CASPER
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 1:12 STULTS RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-2514
Mailing Address - Country:US
Mailing Address - Phone:732-329-8600
Mailing Address - Fax:609-395-7519
Practice Address - Street 1:12 STULTS RD
Practice Address - Street 2:SUITE 121
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-2514
Practice Address - Country:US
Practice Address - Phone:732-329-8600
Practice Address - Fax:609-395-7519
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA042718207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5631505Medicaid
D06775Medicare UPIN
NJ5631505Medicaid