Provider Demographics
NPI:1528329042
Name:TARAWALLY, VARLEE
Entity type:Individual
Prefix:
First Name:VARLEE
Middle Name:
Last Name:TARAWALLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 LANDOVER RD
Mailing Address - Street 2:APT. # T1
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1422
Mailing Address - Country:US
Mailing Address - Phone:240-550-8821
Mailing Address - Fax:
Practice Address - Street 1:6515 LANDOVER RD
Practice Address - Street 2:APT. # T1
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1422
Practice Address - Country:US
Practice Address - Phone:240-550-8821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide