Provider Demographics
NPI:1841234473
Name:KASURI, JASBIR K (MD)
Entity Type:Individual
Prefix:
First Name:JASBIR
Middle Name:K
Last Name:KASURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:340 ROUTE 1
Mailing Address - Street 2:REDWOOD AVENUE
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4489
Mailing Address - Country:US
Mailing Address - Phone:732-777-1010
Mailing Address - Fax:732-777-1266
Practice Address - Street 1:340 ROUTE 1
Practice Address - Street 2:REDWOOD AVENUE
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4489
Practice Address - Country:US
Practice Address - Phone:732-777-1010
Practice Address - Fax:732-777-1266
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA54616207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6079105Medicaid
NJ6079105Medicaid
NJ755567Medicare PIN