Provider Demographics
NPI:1487688537
Name:GOLDBERG, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HOSPITAL PLZ
Mailing Address - Street 2:STE 314
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3096
Mailing Address - Country:US
Mailing Address - Phone:732-324-3250
Mailing Address - Fax:732-324-3255
Practice Address - Street 1:390 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-2110
Practice Address - Country:US
Practice Address - Phone:732-738-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04981500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2813814000OtherAMERIHEALTH #
NJLP215OtherOXFORD ID #
NJ3K5155OtherHEALTHNET #
NJ810C51OtherEMPIRE BC OF NY ID #
NJ8223751OtherGHI PPO ID #
NJ1104439OtherAETNA HMO ID #
NJ4263437OtherAETNA PPO ID #
NJ3K5155OtherHEALTHNET #
NJLP215OtherOXFORD ID #