Provider Demographics
NPI:1912779109
Name:VARGHESE, ANITHA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ANITHA
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1942
Mailing Address - Country:US
Mailing Address - Phone:646-250-7412
Mailing Address - Fax:
Practice Address - Street 1:37 MEADOW LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1942
Practice Address - Country:US
Practice Address - Phone:646-250-7412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY537857163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health