Provider Demographics
NPI:1265639611
Name:GOSEIN, VARENDRA JHANAK (MD)
Entity Type:Individual
Prefix:DR
First Name:VARENDRA
Middle Name:JHANAK
Last Name:GOSEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15 ROEBLING ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2362
Mailing Address - Country:US
Mailing Address - Phone:352-262-6999
Mailing Address - Fax:
Practice Address - Street 1:109 N 12TH ST STE 507
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-1002
Practice Address - Country:US
Practice Address - Phone:415-917-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1331442084P0800X
FLTRN11500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine