Provider Demographics
NPI:1558578153
Name:KARL J.F. GOSSNER,M.D.
Entity Type:Organization
Organization Name:KARL J.F. GOSSNER,M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOSSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-683-5343
Mailing Address - Street 1:716 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1529
Mailing Address - Country:US
Mailing Address - Phone:609-683-5343
Mailing Address - Fax:
Practice Address - Street 1:716 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1529
Practice Address - Country:US
Practice Address - Phone:609-683-5343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 199952084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC 52738Medicare UPIN