Healthcare Provider Details

I. General information

NPI: 1740498575
Provider Name (Legal Business Name): NEIL C. GEMINDER MSSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 LEE ST
PERTH AMBOY NJ
08861-3053
US

IV. Provider business mailing address

216 S 3RD AVE
HIGHLAND PARK NJ
08904-2514
US

V. Phone/Fax

Practice location:
  • Phone: 732-442-1666
  • Fax:
Mailing address:
  • Phone: 732-247-5932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: