Provider Demographics
NPI:1801232855
Name:DRROBERTBERCKESLLC
Entity Type:Organization
Organization Name:DRROBERTBERCKESLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BERCKES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-863-6881
Mailing Address - Street 1:199 FLANAGAN WAY
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3437
Mailing Address - Country:US
Mailing Address - Phone:201-863-6881
Mailing Address - Fax:201-863-7852
Practice Address - Street 1:199 FLANAGAN WAY
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3437
Practice Address - Country:US
Practice Address - Phone:201-863-6881
Practice Address - Fax:201-863-7852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty