Provider Demographics
NPI:1215823844
Name:MUANAMPUTU, GAEL FRANCIS
Entity type:Individual
Prefix:
First Name:GAEL
Middle Name:FRANCIS
Last Name:MUANAMPUTU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 REGENCY CRESCENT
Mailing Address - Street 2:
Mailing Address - City:LAKESHORE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N0R1A0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:355 GRAND ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4321
Practice Address - Country:US
Practice Address - Phone:201-919-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program