Tasha Lee Godbolt
NPI #1457034951 in Roselle Park, New Jersey
Provider Information
- NPI Number
- 1457034951
- Entity Type
- Individual
- Name
- Tasha Lee Godbolt
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine - Adult Medicine
- Enumeration Date
- Aug 10, 2023
- Last Updated
- Feb 26, 2024
Practice Location
- Address
- 141 CHESTNUT ST STE 201
- City
- Roselle Park
- State
- New Jersey
- ZIP Code
- 07204-2282
- Phone
- (973) 223-2933
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Adult Medicine — Adult Medicine |
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