Provider Demographics
NPI:1194152710
Name:VARGHESE, ANITA (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:JOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-9684
Mailing Address - Country:US
Mailing Address - Phone:516-318-0099
Mailing Address - Fax:
Practice Address - Street 1:301 S 7TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1449
Practice Address - Country:US
Practice Address - Phone:484-628-4630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11150800207R00000X, 207RI0200X
PAMD476259207R00000X, 207RI0200X
NY270802207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine