Individual
THEODORE ANDREW KASTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,M.S.
Contact information
Practice address
1285 BROAD ST, BLOOMFIELD, NJ 07003-3045
(973) 338-4200
Mailing address
1285 BROAD ST, BLOOMFIELD, NJ 07003-3045
(973) 338-4200
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
MA47761
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1212907
—
NJ
Enumeration date
07/14/2006
Last updated
04/30/2009
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