Provider Demographics
NPI:1639929920
Name:KERSKA, MARY ELIZABETH KELLY (DC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH KELLY
Last Name:KERSKA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 CANTERBURY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-4917
Mailing Address - Country:US
Mailing Address - Phone:651-231-2709
Mailing Address - Fax:
Practice Address - Street 1:1901 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-1600
Practice Address - Country:US
Practice Address - Phone:651-231-2709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00804200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor