MEDICARE: GARY OXENBERG MD

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	207Q00000X	Family Medicine Physician	MD039259L	PA
2	207R00000X	Internal Medicine Physician	25MA10211100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346214533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY OXENBERG MD

Provider Business Mailing Address
First Line	:	2106 NEW RD STE F2
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1053
Country	:	US
Telephone Number	:	609-796-7969
Fax Number	:

Provider Business Practice Location Address
First Line	:	1418 NEW RD STE 2
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1179
Country	:	US
Telephone Number	:	609-796-7969
Fax Number	:

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	10/16/2025

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