Provider Demographics
NPI:1528053659
Name:VARSHAVSKIY, OSKAR (MD, DO)
Entity type:Individual
Prefix:
First Name:OSKAR
Middle Name:
Last Name:VARSHAVSKIY
Suffix:
Gender:M
Credentials:MD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 4TH AVE
Mailing Address - Street 2:SUITE#5
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3244
Mailing Address - Country:US
Mailing Address - Phone:718-836-0761
Mailing Address - Fax:718-836-7369
Practice Address - Street 1:7510 4TH AVE
Practice Address - Street 2:SUITE#5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3244
Practice Address - Country:US
Practice Address - Phone:718-836-0761
Practice Address - Fax:718-836-7369
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225135207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0002339715Medicaid
NY0002339715Medicaid
NYH68945Medicare UPIN