Provider Demographics
NPI:1346691961
Name:VARUGHESE, NITIN (DO)
Entity type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:VARUGHESE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:HHC-CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:860-972-5507
Mailing Address - Fax:860-972-7040
Practice Address - Street 1:192 WESTPORT AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5231
Practice Address - Country:US
Practice Address - Phone:203-853-2610
Practice Address - Fax:203-229-0091
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10537500207Q00000X
CT81123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine