Provider Demographics
NPI:1619929627
Name:DUMAPIT, GERARDO DOMINADO (MD)
Entity Type:Individual
Prefix:
First Name:GERARDO
Middle Name:DOMINADO
Last Name:DUMAPIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 OAK TREE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5127
Mailing Address - Country:US
Mailing Address - Phone:908-822-1213
Mailing Address - Fax:908-822-1088
Practice Address - Street 1:906 OAK TREE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5127
Practice Address - Country:US
Practice Address - Phone:908-822-1213
Practice Address - Fax:908-822-1088
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06258900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG58153Medicare UPIN
NJ959120Medicare ID - Type Unspecified