Provider Demographics
NPI:1982963021
Name:STARKE, JOHN JAMES JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAMES
Last Name:STARKE
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:EMERGENCY DEPARTMENT OFFICES, SUITE D11
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-6671
Mailing Address - Fax:973-282-0562
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT OFFICES, SUITE D11
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-6671
Practice Address - Fax:973-282-0562
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS017216207P00000X
NY269403207P00000X
NJ25MB09227400207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03612897Medicaid