Provider Demographics
NPI:1235167842
Name:KOVACS, JORDAN L (DC)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:L
Last Name:KOVACS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 STATE ROUTE 35
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1885
Mailing Address - Country:US
Mailing Address - Phone:732-389-2800
Mailing Address - Fax:732-389-0246
Practice Address - Street 1:117 STATE ROUTE 35
Practice Address - Street 2:SUITE 2
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1885
Practice Address - Country:US
Practice Address - Phone:732-389-2800
Practice Address - Fax:732-389-0246
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00593000111N00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU89161Medicare UPIN
NJ099022Medicare ID - Type Unspecified