Individual
DR. JOHN F BERTAGNOLLI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
42 E LAUREL RD STE 1800, STRATFORD, NJ 08084-1338
(856) 566-6843
(856) 566-6419
Mailing address
42 E LAUREL RD STE 1800, STRATFORD, NJ 08084-1338
(856) 566-6843
(856) 566-6419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB04458900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104946CKP
MEDICARE ID
NJ
05
—
7634501
—
NJ
Enumeration date
01/19/2006
Last updated
07/21/2022
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