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General NPI Number Information
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NPI Number | 1184666273
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Entity Type | Individual
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Provider Name | RAYMOL M VARGHESE M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 760 BROADWAY WOODHULL VMEDICAL AND MENTAL HEALTH CENTER
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City | BROOKLYN
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State | NY
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Zip | 11206-5317
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Country | US
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Telephone | 718-963-9779
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Fax | 718-963-7957
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Provider Business Mailing Address
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Address Line | 35 WHITTIER DR
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City | ALBERTSON
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State | NY
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Zip | 11507-1016
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Country | US
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Telephone | 516-484-0238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 146303
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License Number State | NY
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