Individual
MR. PRADOSH VARGHESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
124 WASHINGTON AVE, NUTLEY, NJ 07110-3502
(973) 695-0885
(973) 771-3575
Mailing address
7 TWINBORO LN, BERGENFIELD, NJ 07621-1245
(551) 497-8255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
25MP00459800
NJ
Other
Enumeration date
12/01/2017
Last updated
06/05/2023
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