Provider Demographics
NPI:1316304553
Name:VARGHESE, SUNILA ELIZABETH (PT)
Entity type:Individual
Prefix:MRS
First Name:SUNILA
Middle Name:ELIZABETH
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TRADE CENTER
Mailing Address - Street 2:SUITE G-700, UNIT 828
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-8244
Mailing Address - Country:US
Mailing Address - Phone:781-202-5401
Mailing Address - Fax:
Practice Address - Street 1:100 TRADE CENTER
Practice Address - Street 2:SUITE G-700, UNIT 828
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-8244
Practice Address - Country:US
Practice Address - Phone:781-202-5401
Practice Address - Fax:781-202-5404
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20374225100000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA475491435OtherEIN #