MEDICARE: DR. JEROLD HOWARD KAMINSKY D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH 8802	FL
2	111N00000X	Chiropractor	X010013	NY
3	111N00000X	Chiropractor	38MC00579300	NJ

General Provider Information

NPI Number	:	1760569594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROLD HOWARD KAMINSKY D.C.

Provider Business Mailing Address
First Line	:	15-18 PARMELEE AVE
Second Line	:
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-1915
Country	:	US
Telephone Number	:	954-234-5268
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 RAMAPO VALLEY RD
Second Line	:
City	:	OAKLAND
State	:	NJ
Zip	:	07436-2711
Country	:	US
Telephone Number	:	201-651-9100
Fax Number	:	201-651-1142

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/01/2021

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