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Individual

BENITA SHAJI VARGHESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
223 N VAN DIEN AVE, RIDGEWOOD, NJ 07450-2726
(201) 447-8000
Mailing address
1 GARRETT CT, CHESTNUT RIDGE, NY 10977-6739
(845) 352-8548

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00897300
NJ

Other

Enumeration date
05/07/2019
Last updated
05/07/2019
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