Individual
MARK S GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4 AMBLER LN, ABERDEEN, NJ 07747-1205
(732) 583-4466
(732) 583-1639
Mailing address
4 AMBLER LN, ABERDEEN, NJ 07747-1205
(732) 583-4466
(732) 583-1639
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00206000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5481007
—
NJ
Enumeration date
09/09/2005
Last updated
10/26/2007
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