Provider Demographics
NPI:1093969164
Name:KAMINETSKY, ERIC JAY (DO, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAY
Last Name:KAMINETSKY
Suffix:
Gender:M
Credentials:DO, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 ROUTE 10 EAST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-891-1213
Mailing Address - Fax:
Practice Address - Street 1:2534 S. 18TH STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:215-463-4363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-15
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA65832207Q00000X
NJ25MB08797100207Q00000X
PAOS018158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine