Provider Demographics
NPI:1720334147
Name:GAMINDE, JET ADAM VIII (PT)
Entity Type:Individual
Prefix:MR
First Name:JET
Middle Name:ADAM
Last Name:GAMINDE
Suffix:VIII
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:EPIFANIO
Other - Middle Name:RAMOS
Other - Last Name:GAMINDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:89 FRANKLIN AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-6047
Mailing Address - Country:US
Mailing Address - Phone:786-380-6803
Mailing Address - Fax:
Practice Address - Street 1:1070 CLIFTON AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3619
Practice Address - Country:US
Practice Address - Phone:973-246-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA014011002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics