Provider Demographics
NPI:1871713222
Name:VARUGHESE, ABY K
Entity type:Individual
Prefix:
First Name:ABY
Middle Name:K
Last Name:VARUGHESE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 ORIENT ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-2833
Mailing Address - Country:US
Mailing Address - Phone:914-423-0450
Mailing Address - Fax:212-281-7279
Practice Address - Street 1:HARLEM DRUGS
Practice Address - Street 2:565 LENOX AVE
Practice Address - City:NEWYORK
Practice Address - State:NY
Practice Address - Zip Code:10037
Practice Address - Country:US
Practice Address - Phone:212-281-7276
Practice Address - Fax:212-281-7279
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist