Provider Demographics
NPI:1447327549
Name:ROBERTS, KARL M (DC)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:M
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FOXWOOD DR APT B
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2627
Mailing Address - Country:US
Mailing Address - Phone:973-865-3935
Mailing Address - Fax:973-983-1022
Practice Address - Street 1:75 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2735
Practice Address - Country:US
Practice Address - Phone:973-983-1300
Practice Address - Fax:973-983-1022
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00545300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ026201Medicare ID - Type Unspecified