Provider Demographics
NPI:1356087340
Name:VAREED, DEVASSYKUTTY K
Entity Type:Individual
Prefix:
First Name:DEVASSYKUTTY
Middle Name:K
Last Name:VAREED
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 1:11 SUNFLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5450
Mailing Address - Country:US
Mailing Address - Phone:267-760-4417
Mailing Address - Fax:215-673-7370
Practice Address - Street 1:9313 KREWSTOWN RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-3710
Practice Address - Country:US
Practice Address - Phone:215-673-7373
Practice Address - Fax:215-673-7370
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039739T183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist