Provider Demographics
NPI:1982173597
Name:KERTMAN, ROBERT JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:KERTMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 BELLS LAKE RD # 2
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-1683
Mailing Address - Country:US
Mailing Address - Phone:856-232-6284
Mailing Address - Fax:
Practice Address - Street 1:1210 ROUTE 130 N STE 1408
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3046
Practice Address - Country:US
Practice Address - Phone:856-829-7200
Practice Address - Fax:856-829-0464
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01520100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist