Provider Demographics
NPI:1538144951
Name:GOLBERT, THOMAS M (M D)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:GOLBERT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2408
Mailing Address - Country:US
Mailing Address - Phone:732-545-0094
Mailing Address - Fax:732-545-2750
Practice Address - Street 1:706 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-243-0100
Practice Address - Fax:609-243-0055
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15709207KA0200X
WI14911020207KA0200X
MN42318207KA0200X
NJ25MA07675400207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ91001697100OtherAMERICHOICE
NJ0150142000OtherAMERIHEALTH
NJ1111081OtherHORIZON NJ FAMILYCARE
NJ2K6971OtherHEALTHNET
NJ015014200OtherKEYSTONE HEALTHPLANEAST
NJ5717N1OtherEMPIRE BC
NJ60004403OtherHORIZON NJ HEALTH
NJ8828709Medicaid
NJ226108OtherU.S. FAMILY HEALTH
NJ3280270OtherCIGNA
NJP3226180OtherOXFORD
NJ01078270OtherAMERIGROUP
NJ2099738OtherGHI
NJ438865OtherWELLCARE
NJ673291OtherUNITED HEALTHCARE
NJ0071731Medicaid
NJ01120220OtherAMERIGROUP
NJ4009241OtherAETNA
NJ039055Medicare PIN
NJ2099738OtherGHI