Individual
DR. J GORDON BOAK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 BINGHAM AVE, OCEAN, NJ 07712-4700
(732) 663-0300
(732) 663-0301
Mailing address
2102 CORLIES AVE, NEPTUNE, NJ 07753-6141
(732) 776-8535
(732) 774-9148
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MA298909
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012181
—
NJ
Enumeration date
03/08/2006
Last updated
07/08/2007
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