Provider Demographics
NPI:1295713790
Name:GILDEN, JAY MURRAY (DC)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:MURRAY
Last Name:GILDEN
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 1:530 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033-1238
Mailing Address - Country:US
Mailing Address - Phone:908-276-8659
Mailing Address - Fax:908-276-8659
Practice Address - Street 1:530 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033-1238
Practice Address - Country:US
Practice Address - Phone:908-276-8659
Practice Address - Fax:908-276-8659
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00114500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1500309Medicaid
NJ1500309Medicaid