Provider Demographics
NPI:1881348902
Name:KASPAREK, STEVEN WILLIAM
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:WILLIAM
Last Name:KASPAREK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:MICHAEL
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 DUNSTER MAIL CTR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-7546
Mailing Address - Country:US
Mailing Address - Phone:314-322-8858
Mailing Address - Fax:
Practice Address - Street 1:1 BOWDOIN ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4201
Practice Address - Country:US
Practice Address - Phone:617-726-6944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program