Individual
MR. SHANE SAMUEL VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3011
(585) 922-5067
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-1900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
301310
NY
208M00000X
Hospitalist Physician
Primary
301310
NY
Other
Enumeration date
05/13/2016
Last updated
01/17/2024
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