Individual
TASHA LEE GODBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 CHESTNUT ST STE 201, ROSELLE PARK, NJ 07204-2282
(973) 223-2933
Mailing address
141 CHESTNUT ST STE 201, ROSELLE PARK, NJ 07204-2282
(973) 223-2933
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
0
NJ
Other
Enumeration date
08/10/2023
Last updated
02/26/2024
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