Provider Demographics
NPI:1790797843
Name:MACKERT, JOHN P (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:MACKERT
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 1:601 BENSEL DR
Mailing Address - Street 2:
Mailing Address - City:LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:07850-1434
Mailing Address - Country:US
Mailing Address - Phone:908-797-9450
Mailing Address - Fax:
Practice Address - Street 1:601 BENSEL DR
Practice Address - Street 2:
Practice Address - City:LANDING
Practice Address - State:NJ
Practice Address - Zip Code:07850-1434
Practice Address - Country:US
Practice Address - Phone:908-797-9450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00583100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ060210Medicare ID - Type Unspecified