Provider Demographics
NPI:1932381670
Name:JOHN MCNERNEY DBA DR JOHN MCNERNEY
Entity Type:Organization
Organization Name:JOHN MCNERNEY DBA DR JOHN MCNERNEY
Other - Org Name:WESTWOOD PODIATRIC SERVICES PA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCNERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-664-2800
Mailing Address - Street 1:490 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-1906
Mailing Address - Country:US
Mailing Address - Phone:201-664-2800
Mailing Address - Fax:201-664-5141
Practice Address - Street 1:490 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-1906
Practice Address - Country:US
Practice Address - Phone:201-664-2800
Practice Address - Fax:201-664-5141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00101600332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174020001OtherMED DMERC WESTWOOD PODIAT
0812520001OtherMED DMERC JE MCNERNEY
1174020001OtherMED DMERC WESTWOOD PODIAT
0812520001OtherMED DMERC JE MCNERNEY