Provider Demographics
NPI:1508839598
Name:GOEHRING, SIDNEY D (BS)
Entity Type:Individual
Prefix:MR
First Name:SIDNEY
Middle Name:D
Last Name:GOEHRING
Suffix:
Gender:M
Credentials:BS
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Mailing Address - Street 1:ROUTE 12 ATTN: PROFESSIONAL AFFAIRS
Mailing Address - Street 2:BLDG 449 NAVAL HEALTH CARE NEW ENGLAND GROTON
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06349-5600
Mailing Address - Country:US
Mailing Address - Phone:860-694-2377
Mailing Address - Fax:860-694-2590
Practice Address - Street 1:43 SMITH RD
Practice Address - Street 2:NAVAL HEALTH CARE NEW ENGLAND NEWPORT
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02841-1002
Practice Address - Country:US
Practice Address - Phone:860-694-2377
Practice Address - Fax:860-694-3590
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIRPH044191835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN