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Tasha Lee Godbolt
Adult Medicine Physician in Roselle Park, New Jersey
NPI 1457034951

Tasha Lee Godbolt is an Adult Medicine Physician based in Roselle Park, NJ and is specialized in Adult Medicine. Tasha Lee Godbolt practices in Roselle Park, NJ. The NPI Number for Tasha Lee Godbolt is 1457034951 and holds a License No. 0 (New Jersey).

The current practice location address for Tasha Lee Godbolt is 141 Chestnut St Ste 201, Roselle Park, NJ and can be reached out via phone at 973-223-2933.

Location: 141 Chestnut St Ste 201, Roselle Park, NJ, 07204-2282
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457034951
Provider Name
Tasha Lee Godbolt
Credential
Provider Entity Type
Individual
Gender
Female
Address
141 Chestnut St Ste 201, Roselle Park, NJ, 07204-2282
Phone Number
973-223-2933
Fax Number
Provider Enumeration Date
08/10/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
141 Chestnut St Ste 201
City
Roselle Park
State
New Jersey
Zip
07204-2282
Phone Number
973-223-2933
Fax Number
person
Provider Business Mailing Address Details
Address
141 Chestnut St Ste 201
City
Roselle Park
State
New Jersey
Zip
07204-2282
Phone Number
973-223-2933
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
0 (New Jersey)
Definition
Definition to come.
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