Male or Other

Mr. Pradosh Varghese

Medical Physician Assistant in Nutley, NJ(View on Map)

Full Name

Mr. Pradosh Varghese

NPI Number

1063927812

NPI Type

Individual Provider

Gender

Male

Enumeration Date

12/01/2017

Specialties

(Taxonomies)

Code

363AM0700X
363A00000X

Primary Taxonomy

Yes
No

Licenses

State

New Jersey

License Number

25MP00459800

Contact
Information

Purpose

Mailing
Location

Address

7 TWINBORO LN
124 WASHINGTON AVE

City

Bergenfield
Nutley

State

NJ
NJ

Postal Code

07621-1245
07110-3502

Country

US
US

Telephone Number

(551) 497-8255
(973) 695-0885

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/05/2023

Provider Address

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