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Individual

DR. JARED MARK WASSERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
433 HACKENSACK AVE STE 204, HACKENSACK, NJ 07601-6319
(201) 883-1062
Mailing address
660 WHITE PLAINS RD FL 4, TARRYTOWN, NY 10591-5139
(914) 984-2546

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
233407
MA
207Y00000X
Otolaryngology Physician
Primary
25MA08244600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D09303400
CDS
NJ
01
P00675979
RAILROAD MEDICARE
NJ
Enumeration date
07/04/2007
Last updated
04/01/2019
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