Provider Demographics
NPI:1063767234
Name:KASTNER, JOAN (PSYCHOLOGIST (PHD))
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:KASTNER
Suffix:
Gender:F
Credentials:PSYCHOLOGIST (PHD)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 SHERWOOD PLACE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:201-394-4318
Mailing Address - Fax:201-568-8719
Practice Address - Street 1:101 E. CEDAR LANE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-394-4318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00417500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist