| Kashoqa Psychiatry Associates Pc | |
|
506 Hamburg Tpke Suite 203 Wayne NJ 07470-2069 | |
| (973) 633-1996 | |
| (973) 633-8078 |
| Full Name | Kashoqa Psychiatry Associates Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 506 Hamburg Tpke, Wayne, New Jersey |
| Authorized Official Name and Position | Amer H Kashoqa (PRESIDENT) |
| Authorized Official Contact | 9736331996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kashoqa Psychiatry Associates Pc 506 Hamburg Tpke Suite 203 Wayne NJ 07470-2069 Ph: (973) 633-1996 | Kashoqa Psychiatry Associates Pc 506 Hamburg Tpke Suite 203 Wayne NJ 07470-2069 Ph: (973) 633-1996 |
| NPI Number | 1568539203 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 07/07/2023 |
| Certification Date | 07/07/2023 |
| Medicare PECOS PAC ID | 8921279472 |
|---|---|
| Medicare Enrollment ID | O20110914000343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568539203 | NPI | - | NPPES |
| 0524018 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MA057427 (New Jersey) | Primary |
| Provider Name | Amer H Kashoqa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972615078 PECOS PAC ID: 9830360387 Enrollment ID: I20110914000362 |
| Provider Name | Sarah Romeo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821380056 PECOS PAC ID: 4688812910 Enrollment ID: I20130529000068 |
| Provider Name | Diane F Dettmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285045757 PECOS PAC ID: 4385862044 Enrollment ID: I20140822000220 |
| Provider Name | Fumitaka Hayashi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255656344 PECOS PAC ID: 3274755251 Enrollment ID: I20150803000492 |
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