Provider Demographics
NPI:1730433186
Name:CHESTER COUNTY INFECTIOUS DISEASES, LLC
Entity type:Organization
Organization Name:CHESTER COUNTY INFECTIOUS DISEASES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NASRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-430-8200
Mailing Address - Street 1:PO BOX 1520
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-0110
Mailing Address - Country:US
Mailing Address - Phone:610-594-7590
Mailing Address - Fax:610-594-7597
Practice Address - Street 1:520 MAPLE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4434
Practice Address - Country:US
Practice Address - Phone:610-430-8200
Practice Address - Fax:610-350-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty