| Doctor Name: | DR. MICHAEL EDWIN KAFRISSEN |
| NPI Number: | 1619205929 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD017180E |
| Business Practice Address: | 1000 Route 202 Raritan, NJ - 088691425 |
| Business Phone Number: | 9087044609 |
| Business Fax Number: | 9082180460 |
| Mailing Address: | Po Box 165, GLADSTONE |
| State: | NJ |
| Postal Code: | 079340165 |
| Phone Number: | 9087044609 |
| Fax Number: | 9082180460 |
| NPI Enumeration Date: | 11/24/2009 |
| NPI Last Update Date: | 11/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD017180E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |