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Individual

JOHNSON VARUGHESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
70 DUBOIS ST, NEWBURGH, NY 12550-4851
(845) 561-4400
Mailing address
484 TEMPLE HILL RD, STE 104, NEW WINDSOR, NY 12553-5557
(845) 565-3700
(845) 565-3395

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012129
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012129
LICENSE
NY
Enumeration date
12/17/2007
Last updated
12/17/2007
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