Provider Demographics
NPI:1124609755
Name:GOLD, JEFFREY (MOT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:GOLD
Suffix:
Gender:M
Credentials:MOT
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:GOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16 KENTWORTH CT
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-3530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3150 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3595
Practice Address - Country:US
Practice Address - Phone:908-552-0996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00985600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist