Provider Demographics
NPI:1922281997
Name:KERNESS, WAYNE JARED (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:JARED
Last Name:KERNESS
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 1:128 SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1927
Mailing Address - Country:US
Mailing Address - Phone:201-660-7194
Mailing Address - Fax:
Practice Address - Street 1:128 SOMERSET RD
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648-1927
Practice Address - Country:US
Practice Address - Phone:201-660-7194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08332600207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery