Provider Demographics
NPI:1043013402
Name:GOSHEA, GEORGIA ANN
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:ANN
Last Name:GOSHEA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 NORTH GAY STREET
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:PA
Mailing Address - Zip Code:17547
Mailing Address - Country:US
Mailing Address - Phone:717-426-5430
Mailing Address - Fax:
Practice Address - Street 1:1808 COLONIAL VILLAGE LN STE 103
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6709
Practice Address - Country:US
Practice Address - Phone:717-391-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN2700012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry