Provider Demographics
NPI:1447334263
Name:GURMAN, JETT (DC)
Entity type:Individual
Prefix:DR
First Name:JETT
Middle Name:
Last Name:GURMAN
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 1:99 KINDERKAMACK RD STE 112
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3020
Mailing Address - Country:US
Mailing Address - Phone:201-664-4888
Mailing Address - Fax:201-664-4501
Practice Address - Street 1:99 KINDERKAMACK RD STE 112
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3020
Practice Address - Country:US
Practice Address - Phone:201-664-4888
Practice Address - Fax:201-664-4501
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MM00277300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ536594Medicare ID - Type Unspecified