Provider Demographics
NPI:1417958109
Name:VARMA, MALA (MD)
Entity Type:Individual
Prefix:
First Name:MALA
Middle Name:
Last Name:VARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-2467
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2467
Mailing Address - Country:US
Mailing Address - Phone:212-523-7281
Mailing Address - Fax:212-523-2004
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:SUITE 11C02
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:212-523-7281
Practice Address - Fax:212-523-2004
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY228297207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02441358Medicaid
NY02441358Medicaid
NY02441358Medicaid