Provider Demographics
NPI:1023816725
Name:MORDAN, JOHN CHARLES
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHARLES
Last Name:MORDAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:CLIFFWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07721-1356
Mailing Address - Country:US
Mailing Address - Phone:201-856-9470
Mailing Address - Fax:
Practice Address - Street 1:58 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:CLIFFWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07721-1356
Practice Address - Country:US
Practice Address - Phone:201-856-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCCHI-4864171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter