IndividualActive
Tasha Godbolt
NPI 1457034951 · Adult Medicine Physician · Roselle Park, NJ
Provider details
- NPI number
- 1457034951
- Entity type
- Individual
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 0 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
141 Chestnut St Ste 201
Roselle Park, NJ 07204-2282
Phone: (973) 223-2933
Approximate (ZIP-level) locationGet directions
Mailing address
141 Chestnut St Ste 201
Roselle Park, NJ 07204-2282
Registry dates
- Enumerated
- 2023-08-10
- Last updated
- 2024-02-26
- Certified
- 2024-02-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.