Provider Demographics
NPI:1619259132
Name:VARUGHESE, SAJU SUNNY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAJU
Middle Name:SUNNY
Last Name:VARUGHESE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 CAMEO CT
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3506
Mailing Address - Country:US
Mailing Address - Phone:516-503-2970
Mailing Address - Fax:
Practice Address - Street 1:301 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-6437
Practice Address - Country:US
Practice Address - Phone:516-485-8774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist