Provider Demographics
NPI:1972199909
Name:KAMINETZ, ANDREW HARRIS
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:HARRIS
Last Name:KAMINETZ
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 1:121 E REDBUD ALY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-2608
Mailing Address - Country:US
Mailing Address - Phone:614-578-4193
Mailing Address - Fax:
Practice Address - Street 1:121 E REDBUD ALY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-2608
Practice Address - Country:US
Practice Address - Phone:614-578-4193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker