Provider Demographics
NPI:1023205549
Name:VARGHESE, BETSY ANNA (LPT)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:ANNA
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1218
Mailing Address - Country:US
Mailing Address - Phone:610-461-6510
Mailing Address - Fax:610-461-0534
Practice Address - Street 1:1412 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1218
Practice Address - Country:US
Practice Address - Phone:610-461-6510
Practice Address - Fax:610-461-0534
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012792L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist