Provider Demographics
NPI:1659347243
Name:VARGHESE, REKHI (MD)
Entity Type:Individual
Prefix:DR
First Name:REKHI
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N. FRANKLIN DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-225-6500
Mailing Address - Fax:724-229-2170
Practice Address - Street 1:125 N. FRANKLIN DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-225-6500
Practice Address - Fax:724-229-2170
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427025174400000X
OH35-098063207RC0000X
OH35.098063207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH073521OtherMEDICARE PTAN
PA101382805Medicaid
OH0065019Medicaid
OH0065019Medicaid