Provider Demographics
NPI:1427127984
Name:MCINERNEY, JOHN F (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:MCINERNEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S MAIN STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2264
Mailing Address - Country:US
Mailing Address - Phone:609-463-1662
Mailing Address - Fax:609-463-1658
Practice Address - Street 1:211 S MAIN STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2264
Practice Address - Country:US
Practice Address - Phone:609-463-1662
Practice Address - Fax:609-463-1658
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI01232103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092944Medicare ID - Type Unspecified