Provider Demographics
NPI:1942275854
Name:GORSKI, EUGENE D (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:D
Last Name:GORSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:102 BANKS AVE
Practice Address - Street 2:
Practice Address - City:SUGARLOAF
Practice Address - State:PA
Practice Address - Zip Code:18249-3709
Practice Address - Country:US
Practice Address - Phone:570-788-5104
Practice Address - Fax:570-788-5777
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027461E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000980000-0005Medicaid
PA0009800000004Medicaid
PAB40633Medicare UPIN