Provider Demographics
NPI:1760569594
Name:KAMINSKY, JEROLD HOWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JEROLD
Middle Name:HOWARD
Last Name:KAMINSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15-18 PARMELEE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1915
Mailing Address - Country:US
Mailing Address - Phone:954-234-5268
Mailing Address - Fax:
Practice Address - Street 1:340 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2711
Practice Address - Country:US
Practice Address - Phone:201-651-9100
Practice Address - Fax:201-651-1142
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8802111N00000X
NYX010013111N00000X
NJ38MC00579300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U87697Medicare UPIN
NJ052502Medicare ID - Type Unspecified
FLU6887ZMedicare ID - Type Unspecified