Jerry Dorestant
Individual provider Active NPI Behavior Technician · Gloucester City, NJ
NPI 1972458693 · NPPES record last updated Feb 27, 2026
Key facts
- NPI
- 1972458693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 709 Powell St
Gloucester City, NJ 08030-2045 - Phone
- (786) 689-0573
- NPI assigned
- Feb 27, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
709 Powell St
Gloucester City, NJ 08030-2045
Mailing address
709 Powell St
Gloucester City, NJ 08030-2045
Other providers in Gloucester City, NJ
- Crowned Communities
- Dag GC PA
- Shawanna Indoneshia Dilworth
- Divine Home Health Care Agency LLC
- Latoyria Djanie
- Dr. Irving J. Klein,PA
- Dr. Larry Charles Wallis LLC
- Edward L. Lundy, D.O.
- Enam Corporation
- Keana Fairfax
All providers in Gloucester City, NJ · Behavior Technician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.