MEDICARE: ASHLEY VAREEDAYAH

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	207RG0100X	Gastroenterology Physician	293497	NY
2	207RG0100X	Gastroenterology Physician	036166243	IL

General Provider Information

NPI Number	:	1386910610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY VAREEDAYAH

Provider Business Mailing Address
First Line	:	240 E 38TH ST FL 23
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-2708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1009 S WOOD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3747
Country	:	US
Telephone Number	:	312-996-7598
Fax Number	:

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

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	01/02/2024

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Directions to “ ASHLEY VAREEDAYAH ” Practice Location

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