Provider Demographics
NPI:1982626016
Name:BEREZNY, JOHN JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:BEREZNY
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 1:240 US HIGHWAY 206
Mailing Address - Street 2:P.O. BOX 716
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9244
Mailing Address - Country:US
Mailing Address - Phone:973-252-0040
Mailing Address - Fax:973-252-0515
Practice Address - Street 1:240 US HIGHWAY 206
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9244
Practice Address - Country:US
Practice Address - Phone:973-252-0040
Practice Address - Fax:973-252-0515
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00456700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3393234OtherOXFORD
NJ6583903Medicaid
NJ223393234OtherTAX ID
NJ5805690OtherGHI
NJ350051028OtherRAILROAD MEDICARE
NJ5805690OtherGHI