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Organization

DEVELOPMENTAL DISABILITIES HEALTH SERVICES PA

Active
Other names
Developmental Disabilites Health Alliance
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THEODORE ANDREW KASTNER M.D., M. S. (PRESIDENT)
(973) 338-4200
Entity
Organization

Contact information

Practice address
1285 BROAD ST, BLOOMFIELD, NJ 07003-3045
(973) 338-4200
(973) 338-4440
Mailing address
1285 BROAD ST, BLOOMFIELD, NJ 07003-3045
(973) 338-4200
(973) 338-4440

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
161730
NJ
05
8448701
NJ
Enumeration date
07/21/2006
Last updated
06/17/2015
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