Provider Demographics
NPI:1578869798
Name:VARRASSO, DENIA ANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:DENIA
Middle Name:ANNA
Last Name:VARRASSO
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 1:1214 WARING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5432
Mailing Address - Country:US
Mailing Address - Phone:718-798-6083
Mailing Address - Fax:718-798-5164
Practice Address - Street 1:1214 WARING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5432
Practice Address - Country:US
Practice Address - Phone:718-798-6083
Practice Address - Fax:718-798-5164
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157193208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00967675Medicaid
NY00967675Medicaid
NYA643333358Medicare UPIN