Healthcare Provider Details

I. General information

NPI: 1518384668
Provider Name (Legal Business Name): AARON P VARGHESE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LATTIMORE RD STE 258
ROCHESTER NY
14620-4155
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 668
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-442-8020
  • Fax:
Mailing address:
  • Phone: 585-442-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number324433
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: