Provider Demographics
NPI:1013065283
Name:BERKENKOPF, JOHN EDWARD (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EDWARD
Last Name:BERKENKOPF
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 VITALOAK LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19054-1219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
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:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03041900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist