MEDICARE: DR. GERARDO V GOLDBERGER DO

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	MB06724800	NJ
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	MB6724800	NJ

General Provider Information

NPI Number	:	1306810726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERARDO V GOLDBERGER DO

Provider Business Mailing Address
First Line	:	301 PROFESSIONAL VIEW DR
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-7904
Country	:	US
Telephone Number	:	732-720-2555
Fax Number	:	732-720-2556

Provider Business Practice Location Address
First Line	:	301 PROFESSIONAL VIEW DR
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-7904
Country	:	US
Telephone Number	:	732-720-2555
Fax Number	:	732-720-2556

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	01/30/2019

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