Provider Demographics
NPI:1821364019
Name:GORSHEIN, ELAN (DO, JD, MPH)
Entity Type:Individual
Prefix:
First Name:ELAN
Middle Name:
Last Name:GORSHEIN
Suffix:
Gender:M
Credentials:DO, JD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:YALE-NEW HAVEN SHORELINE MEDICAL CENTER
Mailing Address - Street 2:111 GOOSE LANE, SUITE 1300
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437
Mailing Address - Country:US
Mailing Address - Phone:203-453-9192
Mailing Address - Fax:203-453-0875
Practice Address - Street 1:YALE-NEW HAVEN SHORELINE MEDICAL CENTER
Practice Address - Street 2:111 GOOSE LANE, SUITE 1300
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437
Practice Address - Country:US
Practice Address - Phone:203-453-9192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-01
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT60343207RH0000X, 207RX0202X, 207RH0003X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program