Provider Demographics
NPI:1932741972
Name:GOSHU, ELENI (NP)
Entity Type:Individual
Prefix:
First Name:ELENI
Middle Name:
Last Name:GOSHU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2319 HANOVER PIKE STE E-F
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-1137
Mailing Address - Country:US
Mailing Address - Phone:410-239-2662
Mailing Address - Fax:410-374-8786
Practice Address - Street 1:2319 HANOVER PIKE STE E-F
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-1137
Practice Address - Country:US
Practice Address - Phone:410-239-2662
Practice Address - Fax:410-374-8786
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR182035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily