Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 225135 | NY |
NPI | 1528053659 |
---|---|
Provider Name | Oskar Varshavskiy |
First Address | Brooklyn, NY 11209-3244 |
Second Address | Brooklyn, NY 11209-3244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0002339715 | (05) | NY |
H68945 | (02) | NY |