Healthcare Provider Details

I. General information

NPI: 1336800911
Provider Name (Legal Business Name): VARSHA PAHWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 HILLSIDE AVE STE J
WILLISTON PARK NY
11596-2352
US

IV. Provider business mailing address

38 GRANT ST
FARMINGDALE NY
11735-6711
US

V. Phone/Fax

Practice location:
  • Phone: 516-800-1332
  • Fax:
Mailing address:
  • Phone: 516-800-1332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01128700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number013021
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: