| NAME |
GOSHEN CBOC |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
30 Hatfield Lane, Suite 204 |
| CITY |
GOSHEN |
| ZIP |
10924-6766 |
| OFFICIAL VA NAME |
GOSHEN CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
GOSHEN VA CLINIC |
| ST. ADDR. 1 (MAILING) |
30 Hatfield Lane, Suite 204 |
| CITY (MAILING) |
GOSHEN |
| STATE (MAILING) |
NEW YORK |
| ZIP (MAILING) |
10924-6766 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1851338776
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
620GD |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1851338776
-
- CODING SYSTEM: VASTANUM
- ID: 620GD
-
- CODING SYSTEM: CLIA
- ID: 33D1094273
|
