Provider Demographics
NPI:1114183969
Name:VARMA, JAYA JOHARI (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYA
Middle Name:JOHARI
Last Name:VARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JAYA
Other - Middle Name:
Other - Last Name:JOHARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF VETERANS AFAIRS
Mailing Address - Street 2:4801 VETERANS DRIVE
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-255-6480
Mailing Address - Fax:320-255-6426
Practice Address - Street 1:4801 VETERANS DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2015
Practice Address - Country:US
Practice Address - Phone:320-255-6480
Practice Address - Fax:320-255-6426
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2425862084P0800X
PAMD4314482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry