Provider Demographics
NPI:1013995182
Name:JASINSKI, DARIUSZ (DPM)
Entity Type:Individual
Prefix:DR
First Name:DARIUSZ
Middle Name:
Last Name:JASINSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 COMLY RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1104
Mailing Address - Country:US
Mailing Address - Phone:201-406-7584
Mailing Address - Fax:973-696-2433
Practice Address - Street 1:7 INDUSTRIAL ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:PEQUANNOCK
Practice Address - State:NJ
Practice Address - Zip Code:07440
Practice Address - Country:US
Practice Address - Phone:201-406-7584
Practice Address - Fax:973-696-2433
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2010-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00280100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJV01648Medicare UPIN