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NPI Code Detail

MEDICARE: DEBORAH RENEE GOSTOWSKI

MEDICARE: DEBORAH RENEE GOSTOWSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist2081IL

General Provider Information

NPI Number : 1285785857
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH RENEE GOSTOWSKI
Provider Business Mailing Address
First Line : 5283 WHALEY ST
Second Line :
City : MULKEYTOWN
State : IL
Zip : 62865-3237
Country : US
Telephone Number : 618-927-1882
Fax Number :
Provider Business Practice Location Address
First Line : 102 W WASHINGTON AVE
Second Line :
City : EFFINGHAM
State : IL
Zip : 62401-2354
Country : US
Telephone Number : 217-347-7234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/08/2007

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Directions to “ DEBORAH RENEE GOSTOWSKI ” Practice Location

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