Provider Demographics
NPI:1629719604
Name:KERNIZAN, JUDE MARLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:JUDE
Middle Name:MARLEY
Last Name:KERNIZAN
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 1:187 WASHINGTON AVE
Mailing Address - Street 2:STE 2B
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1995
Mailing Address - Country:US
Mailing Address - Phone:609-647-7011
Mailing Address - Fax:
Practice Address - Street 1:187 WASHINGTON AVE STE 2B
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1995
Practice Address - Country:US
Practice Address - Phone:973-661-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00791100111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation