MEDICARE: DR. VARENDRA JHANAK GOSEIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A133144	CA
2	207R00000X	Internal Medicine Physician	TRN11500	FL

General Provider Information

NPI Number	:	1265639611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VARENDRA JHANAK GOSEIN M.D.

Provider Business Mailing Address
First Line	:	15 ROEBLING ST APT 3A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-2362
Country	:	US
Telephone Number	:	352-262-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 N 12TH ST STE 507
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-1002
Country	:	US
Telephone Number	:	415-917-3772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	04/27/2022

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