Provider Demographics
NPI:1730315268
Name:VARUGHESE, REENA MARY (DPT)
Entity Type:Individual
Prefix:DR
First Name:REENA
Middle Name:MARY
Last Name:VARUGHESE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BOULEVARD E APT 4EE
Mailing Address - Street 2:
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086-6843
Mailing Address - Country:US
Mailing Address - Phone:201-274-9288
Mailing Address - Fax:
Practice Address - Street 1:120 E 56TH ST
Practice Address - Street 2:SUITE 1010
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3607
Practice Address - Country:US
Practice Address - Phone:212-759-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030720225100000X
NJ40Q01180400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist