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Individual

MRS. PINKY VARGHESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPA-C

Contact information

Practice address
120 BETHPAGE ROAD, SUITE 310, HICKSVILLE, NY 11801
(516) 822-6655
Mailing address
681 SHERMAN CT, WESTBURY, NY 11590-5417
(516) 414-7160

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
010458
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201246306
TAX ID
NY
Enumeration date
02/08/2011
Last updated
12/10/2014
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