Provider Demographics
NPI:1710921804
Name:GOLD, MARCIA DIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:DIANE
Last Name:GOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 8519
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-8519
Mailing Address - Country:US
Mailing Address - Phone:732-460-9840
Mailing Address - Fax:732-460-9848
Practice Address - Street 1:18 LEONARDVILLE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2311
Practice Address - Country:US
Practice Address - Phone:732-671-0860
Practice Address - Fax:732-671-6467
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA50817207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE53232Medicare UPIN