Healthcare Provider Details

I. General information

NPI: 1477480150
Provider Name (Legal Business Name): GOLD GROUP ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 LAKE AVE STE 3
ASBURY PARK NJ
07712-7172
US

IV. Provider business mailing address

619 LAKE AVE STE 3
ASBURY PARK NJ
07712-7172
US

V. Phone/Fax

Practice location:
  • Phone: 732-547-2304
  • Fax:
Mailing address:
  • Phone: 732-547-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CONNA CRINCOLI
Title or Position: CFO
Credential:
Phone: 732-547-2304