Healthcare Provider Details

I. General information

NPI: 1427437763
Provider Name (Legal Business Name): BENJAMIN M. GILIBERTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776 SHREWSBURY AVE SUITE 201
TINTON FALLS NJ
07724
US

IV. Provider business mailing address

776 SHREWSBURY AVE SUITE 201
TINTON FALLS NJ
07724
US

V. Phone/Fax

Practice location:
  • Phone: 732-530-4949
  • Fax: 732-212-1171
Mailing address:
  • Phone: 732-530-4949
  • Fax: 732-212-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD88772
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA10421900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: