Provider Demographics
NPI:1952459125
Name:BERKENKOPF, JOHN WALTER (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WALTER
Last Name:BERKENKOPF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 RICHMOND AVE.
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3560
Mailing Address - Country:US
Mailing Address - Phone:609-586-4698
Mailing Address - Fax:609-586-2076
Practice Address - Street 1:1125 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-5801
Practice Address - Country:US
Practice Address - Phone:609-393-3017
Practice Address - Fax:609-396-3459
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01222800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist