Healthcare Provider Details

I. General information

NPI: 1346214533
Provider Name (Legal Business Name): GARY OXENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 NEW RD STE 2
NORTHFIELD NJ
08225-1179
US

IV. Provider business mailing address

2106 NEW RD STE F2
LINWOOD NJ
08221-1053
US

V. Phone/Fax

Practice location:
  • Phone: 609-796-7969
  • Fax:
Mailing address:
  • Phone: 609-796-7969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD039259L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10211100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: