Provider Demographics
NPI:1053429498
Name:KAMINSKI, JOHN J JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:KAMINSKI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-777-1096
Mailing Address - Fax:603-580-7210
Practice Address - Street 1:879 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1258
Practice Address - Country:US
Practice Address - Phone:603-929-1195
Practice Address - Fax:603-929-1196
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077421Medicaid
NH0107607YPNH01OtherANTHEM BC/BS
NH30001656Medicaid
NH30001656Medicaid
NH0107607YPNH01OtherANTHEM BC/BS