Provider Demographics
NPI:1861402562
Name:KASTUAR, SATYA P (MD)
Entity type:Individual
Prefix:
First Name:SATYA
Middle Name:P
Last Name:KASTUAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1020
Mailing Address - Country:US
Mailing Address - Phone:732-821-0011
Mailing Address - Fax:732-821-2998
Practice Address - Street 1:2480 ROUTE 27
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1020
Practice Address - Country:US
Practice Address - Phone:732-821-0011
Practice Address - Fax:732-821-2998
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04124800207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1110101Medicaid
NJ177861Medicare Oscar/Certification
177859YAFFMedicare PIN
NJ1110101Medicaid