Healthcare Provider Details

I. General information

NPI: 1689620973
Provider Name (Legal Business Name): GOSHEN MEDICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 HATFIELD LN SUITE 101
GOSHEN NY
10924-6734
US

IV. Provider business mailing address

70 HATFIELD LN SUITE 101
GOSHEN NY
10924-6734
US

V. Phone/Fax

Practice location:
  • Phone: 845-294-8888
  • Fax: 845-294-1669
Mailing address:
  • Phone: 845-294-8888
  • Fax: 845-294-1669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM CIEPLINSKI
Title or Position: OFFICER
Credential: MD
Phone: 845-294-8888