Provider Demographics
NPI:1750361838
Name:KAISER-SMITH, JOANNE (DO)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:KAISER-SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 E LAUREL RD STE 3100-A
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1354
Mailing Address - Country:US
Mailing Address - Phone:856-566-7070
Mailing Address - Fax:856-566-7002
Practice Address - Street 1:42 E LAUREL RD STE 3100-A
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1354
Practice Address - Country:US
Practice Address - Phone:856-566-7070
Practice Address - Fax:856-566-7002
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB04779800207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ110113133OtherRAILROAD MEDICARE
NJ1793004Medicaid
NJ110113133OtherRAILROAD MEDICARE
NJC54060Medicare UPIN