Provider Demographics
NPI:1740535806
Name:KASTEN, MITCHELL JEFFREY (DPM)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:JEFFREY
Last Name:KASTEN
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 1:161 KENTUCKY WAY
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-4631
Mailing Address - Country:US
Mailing Address - Phone:732-768-3177
Mailing Address - Fax:
Practice Address - Street 1:161 KENTUCKY WAY
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-4631
Practice Address - Country:US
Practice Address - Phone:732-409-2945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003864-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist