Individual
DR. JACK M KANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
107 VINE ST, HAMMONTON, NJ 08037-1447
(609) 561-7666
(609) 567-8347
Mailing address
134 BRIDGETON PIKE, MULLICA HILL, NJ 08062-2616
(856) 507-2783
(856) 221-4138
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MB51473
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1006475
MERCY
—
01
—
110132972
RR MEDICARE
NJ
01
—
23054
AETNA
NJ
05
—
2330105
—
NJ
01
—
290002755
RR MEDICARE
NJ
01
—
532646
IBC
NJ
01
—
J27185
HEALTHNET
NJ
01
—
P369523
DXFDRD
NJ
Enumeration date
08/02/2006
Last updated
11/20/2025
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