Healthcare Provider Details

I. General information

NPI: 1619266798
Provider Name (Legal Business Name): VINOD MATHEW VARKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5008 BRITTONFIELD PKWY
EAST SYRACUSE NY
13057-9248
US

IV. Provider business mailing address

5008 BRITTONFIELD PKWY
EAST SYRACUSE NY
13057-9248
US

V. Phone/Fax

Practice location:
  • Phone: 315-472-7504
  • Fax: 315-634-4677
Mailing address:
  • Phone: 315-472-7504
  • Fax: 315-634-4677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number271014
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: