Provider Demographics
NPI:1871610782
Name:GOSHEN FAMILY MEDICINE, LLC
Entity type:Organization
Organization Name:GOSHEN FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-692-6787
Mailing Address - Street 1:1450 E BOOT RD
Mailing Address - Street 2:SUITE 600B
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5300
Mailing Address - Country:US
Mailing Address - Phone:610-692-6787
Mailing Address - Fax:610-692-5706
Practice Address - Street 1:1450 E BOOT RD
Practice Address - Street 2:SUITE 600B
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5300
Practice Address - Country:US
Practice Address - Phone:610-692-6787
Practice Address - Fax:610-692-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036155E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty