Provider Demographics
NPI:1265836407
Name:GAYED, JONATHAN (DPT, OCS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:GAYED
Suffix:
Gender:M
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 LEIGH TER
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-3915
Mailing Address - Country:US
Mailing Address - Phone:201-310-4465
Mailing Address - Fax:
Practice Address - Street 1:649 LEIGH TER
Practice Address - Street 2:
Practice Address - City:TOWNSHIP OF WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07676-3915
Practice Address - Country:US
Practice Address - Phone:551-233-9110
Practice Address - Fax:551-233-0644
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA015617002251X0800X
NJ#40QA015617002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic