Healthcare Provider Details

I. General information

NPI: 1497384598
Provider Name (Legal Business Name): JONATHAN GABOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EAGLE AVE
OCEAN NJ
07712-7631
US

IV. Provider business mailing address

1200 EAGLE AVE
OCEAN NJ
07712-7631
US

V. Phone/Fax

Practice location:
  • Phone: 732-660-6200
  • Fax: 732-660-6201
Mailing address:
  • Phone: 732-660-6200
  • Fax: 732-660-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number25MA13187400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: