Provider Demographics
NPI:1760546733
Name:GOLD, JESSICA (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CAMPUS DR. 373E
Mailing Address - Street 2:CVS HEALTH
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932
Mailing Address - Country:US
Mailing Address - Phone:973-377-5989
Mailing Address - Fax:
Practice Address - Street 1:200 CAMPUS DR. 373E
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932
Practice Address - Country:US
Practice Address - Phone:908-377-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08446700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine