Provider Demographics
NPI:1154054666
Name:VARADARAJAN, SHREENATH
Entity Type:Individual
Prefix:
First Name:SHREENATH
Middle Name:
Last Name:VARADARAJAN
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 1:7417 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7354
Mailing Address - Country:US
Mailing Address - Phone:909-647-8131
Mailing Address - Fax:
Practice Address - Street 1:10051 FOXES WAY
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-3458
Practice Address - Country:US
Practice Address - Phone:540-775-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-03
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist