MEDICARE: DR. SUJA MARY VARUGHESE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	058613-1	NY

General Provider Information

NPI Number	:	1033533633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUJA MARY VARUGHESE PHARMD

Provider Business Mailing Address
First Line	:	421 GLEN COVE RD
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11577
Country	:	US
Telephone Number	:	516-621-5959
Fax Number	:	516-621-3184

Provider Business Practice Location Address
First Line	:	421 GLEN COVE RD
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1811
Country	:	US
Telephone Number	:	516-621-5959
Fax Number	:	516-621-3184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	02/18/2014

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