Provider Demographics
NPI:1104230929
Name:GOSEK, CLARE (MD)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:GOSEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4056 QUAKERBRIDGE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4779
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4056 QUAKERBRIDGE RD STE 101
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4779
Practice Address - Country:US
Practice Address - Phone:609-528-9150
Practice Address - Fax:609-528-9151
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0116026870207Q00000X
NJ25MA11045400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine