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Individual

ERNESTO B GO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1450 E CHESTNUT AVE, BUILDING 4, SUITE A, VINELAND, NJ 08361-8467
(856) 794-8664
(856) 794-2671
Mailing address
2384 FRANKLIN DR, VINELAND, NJ 08361-6673

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA02907100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0073104000
AMERIHEALTH
NJ
01
1156712
HORIZON NJ HEALTH
NJ
05
2153505
NJ
01
300127248
RAILROAD MEDICARE
NJ
01
812429
MEDICARE OF NJ
NJ
Enumeration date
05/27/2006
Last updated
09/11/2019
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