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NPI Code Detail

MEDICARE: EDWARD J GOLD M.D.

MEDICARE: EDWARD J GOLD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMA43772NJ

General Provider Information

NPI Number : 1831168194
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD J GOLD M.D.
Provider Business Mailing Address
First Line : PO BOX 419430
Second Line :
City : BOSTON
State : MA
Zip : 02241-9430
Country : US
Telephone Number : 201-666-3900
Fax Number : 201-261-0505
Provider Business Practice Location Address
First Line : 452 OLD HOOK RD
Second Line : 2ND FLOOR
City : EMERSON
State : NJ
Zip : 07630-1381
Country : US
Telephone Number : 201-666-3900
Fax Number : 201-261-0505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 12/08/2017

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