Provider Demographics
NPI:1467493569
Name:NEIBERT, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:NEIBERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:280 RIVER RD
Mailing Address - Street 2:APT 94B
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3564
Mailing Address - Country:US
Mailing Address - Phone:201-232-5018
Mailing Address - Fax:
Practice Address - Street 1:10 HURON AVE
Practice Address - Street 2:SUITE 1 L
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:201-798-6200
Practice Address - Fax:201-798-6207
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2019-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA066666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7425104Medicaid
NJ7425104Medicaid
G62230Medicare UPIN