Provider Demographics
NPI:1417096231
Name:JANKOVIC, STEPHEN J (DC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:JANKOVIC
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 1:1309 VEALE RD STE 12
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4609
Mailing Address - Country:US
Mailing Address - Phone:302-478-1443
Mailing Address - Fax:302-478-1442
Practice Address - Street 1:2103 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:HAMILTON HEALTHCARE CENTER
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-890-2222
Practice Address - Fax:609-890-0715
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T77829Medicare UPIN
093936Medicare ID - Type Unspecified