Provider Demographics
NPI:1619957628
Name:VARADHAN, JANAKI (MD)
Entity Type:Individual
Prefix:
First Name:JANAKI
Middle Name:
Last Name:VARADHAN
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 1:4 MEETING HOUSE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824
Mailing Address - Country:US
Mailing Address - Phone:978-256-7200
Mailing Address - Fax:978-258-5855
Practice Address - Street 1:4 MEETING HOUSE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824
Practice Address - Country:US
Practice Address - Phone:978-256-7200
Practice Address - Fax:978-258-5855
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72559208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
J09914Medicare ID - Type Unspecified
E32620Medicare UPIN