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General NPI Number Information
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NPI Number | 1194137661
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Entity Type | Individual
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Provider Name | POONAM VARSANI
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Gender | Female
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 385 TREMONT AVE
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City | EAST ORANGE
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State | NJ
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Zip | 07018-1023
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Country | US
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Telephone | 973-676-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 16481 MAGNOLIA ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-7827
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Country | US
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Telephone | 714-848-0028
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Fax | 714-842-0160
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14909
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License Number State | CA
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