Provider Demographics
NPI:1386842508
Name:VARGHESE, NOEL (DO)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 3RD ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1305
Mailing Address - Country:US
Mailing Address - Phone:518-481-2896
Mailing Address - Fax:518-481-2895
Practice Address - Street 1:16 3RD ST
Practice Address - Street 2:SUITE C
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1305
Practice Address - Country:US
Practice Address - Phone:518-481-2896
Practice Address - Fax:518-481-2895
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244733207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology