Individual
VARGHESE SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
197 HALF HOLLOW RD, DIX HILLS, NY 11746-5859
(631) 370-1693
Mailing address
197 HALF HOLLOW RD, DIX HILLS, NY 11746-5859
(631) 370-1693
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
779253
NY
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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