Provider Demographics
NPI:1447408745
Name:VARA, PATRICIA MARY (ANP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARY
Last Name:VARA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 KAYLA DR
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-2793
Mailing Address - Country:US
Mailing Address - Phone:845-628-4793
Mailing Address - Fax:
Practice Address - Street 1:275 NORTH STREET
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528
Practice Address - Country:US
Practice Address - Phone:845-628-4793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301391-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health