Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 25MD00220600 | NJ |
Y | 222Z00000X | Podiatrist | 25MD00220600 | NJ |
NPI | 1053347385 |
---|---|
Provider Name | Dr. Scott Alan Goler |
First Address | Ridgewood, NJ 07450-5326 |
Second Address | Lodi, NJ 07644-2235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 09/05/2008 |