Provider Demographics
NPI:1992985600
Name:VARGHESE, BINCY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:BINCY
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BRETTON RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3412
Mailing Address - Country:US
Mailing Address - Phone:516-567-2395
Mailing Address - Fax:
Practice Address - Street 1:10 BRETTON RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3412
Practice Address - Country:US
Practice Address - Phone:516-567-2395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02897318Medicaid