Provider Demographics
NPI:1316114069
Name:GOOCH, TONI M (CRNP)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:M
Last Name:GOOCH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:M
Other - Last Name:MINKUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:978 IRIS DR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642
Mailing Address - Country:US
Mailing Address - Phone:412-751-0200
Mailing Address - Fax:
Practice Address - Street 1:605 SCENERY DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:PA
Practice Address - Zip Code:15037-2000
Practice Address - Country:US
Practice Address - Phone:412-751-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP006411B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily