Provider Demographics
NPI:1770688137
Name:MCKEON, JOHN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:MCKEON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:585 CRANBURY ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816
Mailing Address - Country:US
Mailing Address - Phone:732-390-1160
Mailing Address - Fax:732-390-8449
Practice Address - Street 1:585 CRANBURY ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-390-1160
Practice Address - Fax:732-390-8449
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2013-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA29260207X00000X
NJ25MA02926000207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3125807Medicaid
NJ3125600Medicare ID - Type Unspecified
NJ3125807Medicaid
NJ035880BR5Medicare PIN