Provider Demographics
NPI:1639170871
Name:OPPENHEIMER, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:OPPENHEIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-656-6280
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:8 SADDLE RD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1902
Practice Address - Country:US
Practice Address - Phone:908-934-0555
Practice Address - Fax:973-540-0472
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05056200207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ30002942OtherRAILROAD MEDICARE
NJ222233003OtherHORIZON BC
NJIS245OtherOXFORD INS.
NJ222233003019OtherCIGNA INS.
NJ67H422OtherEMPIRE HEALTH
NJ121677OtherCHN INS.
NJ4263616OtherAETNA
NJ5534500Medicaid
NJ222233003OtherHORIZON BC
NJE89639Medicare UPIN