Provider Demographics
NPI:1326370925
Name:TREMATORE, JAIMIE MARIE (MED, LDTC, BCBA)
Entity Type:Individual
Prefix:MS
First Name:JAIMIE
Middle Name:MARIE
Last Name:TREMATORE
Suffix:
Gender:F
Credentials:MED, LDTC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W PASSAIC ST
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1235
Mailing Address - Country:US
Mailing Address - Phone:201-417-8076
Mailing Address - Fax:
Practice Address - Street 1:131 W PASSAIC ST
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1235
Practice Address - Country:US
Practice Address - Phone:201-417-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-06
Last Update Date:2010-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-09-6263103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst