Provider Demographics
NPI:1144087479
Name:JASPER, LUCA PHILIP (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:LUCA
Middle Name:PHILIP
Last Name:JASPER
Suffix:
Gender:M
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MANRODT CT
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3309
Mailing Address - Country:US
Mailing Address - Phone:973-464-7159
Mailing Address - Fax:
Practice Address - Street 1:51 JFK PKWY FL 1
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2713
Practice Address - Country:US
Practice Address - Phone:973-404-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15072900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health