Provider Demographics
NPI:1952367062
Name:KLINGERT, RICHARD MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:KLINGERT
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 1:1319 OLD ZION RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-7638
Mailing Address - Country:US
Mailing Address - Phone:609-653-1100
Mailing Address - Fax:609-653-1820
Practice Address - Street 1:1319 OLD ZION RD
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-7638
Practice Address - Country:US
Practice Address - Phone:609-653-1100
Practice Address - Fax:609-653-1820
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00151000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU24629Medicare UPIN
NJ165386AG9Medicare PIN