Johannes H Dejong, M.D.

Individual provider Active NPI Independent Medical Examiner Physician · Brielle, NJ

NPI 1194029926 · NPPES record last updated Jan 9, 2011

Key facts

NPI
1194029926
Entity type
Individual (NPI type 1)
Primary specialty
Independent Medical Examiner Physician 202C00000X
License
25MA01868000 (NJ)
Practice address
4 Captain Bailey CT
Brielle, NJ 08730-1553
Phone
(732) 785-0151
Fax
(732) 785-7761
NPI assigned
Jan 9, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA01868000NJMDIndependent Medical Examiner Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Physician 202C00000X 25MA01868000 NJ Yes

Addresses

Primary practice location

4 Captain Bailey CT
Brielle, NJ 08730-1553

Mailing address

4 Captain Bailey CT
Brielle, NJ 08730-1553
Phone (732) 785-0151

Other providers in Brielle, NJ

All providers in Brielle, NJ · Independent Medical Examiner Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.