Provider Demographics
NPI:1558430645
Name:VARMA, SUJANI
Entity Type:Individual
Prefix:MRS
First Name:SUJANI
Middle Name:
Last Name:VARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SUJANI
Other - Middle Name:
Other - Last Name:RAJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1341 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360
Mailing Address - Country:US
Mailing Address - Phone:718-347-7697
Mailing Address - Fax:718-347-7697
Practice Address - Street 1:1341 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1209
Practice Address - Country:US
Practice Address - Phone:718-347-7697
Practice Address - Fax:718-347-7697
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241749208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation