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Individual

DR. NEIL ELLIS GOLDBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
228 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2202
(973) 762-9060
(973) 762-5056
Mailing address
9 WASHINGTON CT, LIVINGSTON, NJ 07039-2118
(973) 535-9060

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
25MD00103900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0857602
NJ
Enumeration date
06/08/2006
Last updated
01/09/2021
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