MEDICARE: BETSY VARGHESE RAJAN NP

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	363LF0000X	Family Nurse Practitioner	344084	NY

General Provider Information

NPI Number	:	1326695917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETSY VARGHESE RAJAN NP

Provider Business Mailing Address
First Line	:	585 NEW LOUDON RD
Second Line	:
City	:	LATHAM
State	:	NY
Zip	:	12110-5773
Country	:	US
Telephone Number	:	518-783-1472
Fax Number	:	518-783-1605

Provider Business Practice Location Address
First Line	:	713 TROY SCHENECTADY RD STE 224
Second Line	:
City	:	LATHAM
State	:	NY
Zip	:	12110-2490
Country	:	US
Telephone Number	:	518-786-6270
Fax Number	:	518-786-6276

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

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	03/02/2026

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