Provider Demographics
NPI:1952956732
Name:KASPRENSKI, JACOB (OD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:KASPRENSKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 HOWERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CATASAUQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18032-1615
Mailing Address - Country:US
Mailing Address - Phone:484-764-8097
Mailing Address - Fax:
Practice Address - Street 1:1088 HOWERTOWN RD
Practice Address - Street 2:
Practice Address - City:CATASAUQUA
Practice Address - State:PA
Practice Address - Zip Code:18032-1615
Practice Address - Country:US
Practice Address - Phone:757-229-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003557152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty