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Individual

DR. JAMIE VARGHESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
25 STANFORD AVE, WEST ORANGE, NJ 07052-2050
(973) 640-0161
Mailing address
25 STANFORD AVE, WEST ORANGE, NJ 07052-2050

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
203599
AK
152W00000X
Optometrist
27OA00709900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
203599
OPTOMETRY LICENSE
AK
Enumeration date
09/02/2021
Last updated
08/26/2024
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