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General NPI Number Information
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NPI Number | 1972574713
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Entity Type | Individual
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Provider Name | LON GOLDBERG D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 3322 RTE 22 BUILDING 1
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City | BRANCHBURG
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State | NJ
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Zip | 08876-3476
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Country | US
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Telephone | 908-704-0100
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Fax | 908-704-0900
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Provider Business Mailing Address
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Address Line | 53 STONE GATE
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1452
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Country | US
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Telephone | 908-704-0100
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Fax | 908-704-0900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB04654000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MB46540
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License Number State | NJ
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