Basic Information
| Provider Information | |||||||||
| NPI: | 1740200328 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VARICAT | ||||||||
| FirstName: | FRANCISCO | ||||||||
| MiddleName: | PRAVEEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ABRAHAM | ||||||||
| OtherFirstName: | PRAVEEN | ||||||||
| OtherMiddleName: | FRANCIS | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | D.O. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3000 ERIE STREET SOUTH | ||||||||
| Address2: | |||||||||
| City: | MASSILLION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308333135 | ||||||||
| FaxNumber: | 4406845952 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 ERIE STREET SOUTH | ||||||||
| Address2: | |||||||||
| City: | MASSILLION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308333135 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 03/13/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 34-008106 | OH | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 2429885 | 05 | OH | MEDICAID | BA8492136 | 01 | DEA NUMBER | OTHER |