Individual
DR. GRIGORY R GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 EAGLE AVE, OCEAN, NJ 07712-7631
(732) 660-6200
(732) 660-6201
Mailing address
1200 EAGLE AVE, OCEAN, NJ 07712-7631
(732) 660-6200
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
25MA08514200
NJ
207XS0117X
Orthopaedic Surgery of the Spine Physician
35-089481
OH
207XS0117X
Orthopaedic Surgery of the Spine Physician
39810
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000485763
ANTHEM
KY
01
—
000000526432
ANTHEM
OH
01
—
165869
NATIONWIDE
OH
Enumeration date
07/09/2006
Last updated
07/30/2020
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