Provider Demographics
NPI:1043005705
Name:KRESCH, JASON DAVID (RN)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:DAVID
Last Name:KRESCH
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 WAYNE AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2608
Mailing Address - Country:US
Mailing Address - Phone:914-874-4488
Mailing Address - Fax:
Practice Address - Street 1:234 WAYNE AVE # 1
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-2608
Practice Address - Country:US
Practice Address - Phone:914-874-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY836658163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse