Provider Demographics
NPI:1811999295
Name:CERF, JOHN L (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:CERF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 SHADYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1716
Mailing Address - Country:US
Mailing Address - Phone:201-934-8076
Mailing Address - Fax:201-934-3305
Practice Address - Street 1:3200 KENNEDY BLVD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3416
Practice Address - Country:US
Practice Address - Phone:201-656-3719
Practice Address - Fax:201-656-4048
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC003005800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4775309Medicaid
NJ4775309Medicaid
NJCE190859Medicare ID - Type Unspecified