Provider Demographics
NPI:1891752945
Name:DR VARANDANI & ASSOCIATES INCORPORATED
Entity Type:Organization
Organization Name:DR VARANDANI & ASSOCIATES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAI
Authorized Official - Middle Name:K
Authorized Official - Last Name:VARANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:226-546-1182
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24277
Mailing Address - Country:US
Mailing Address - Phone:276-546-1182
Mailing Address - Fax:276-546-2497
Practice Address - Street 1:1119 LAKE ST
Practice Address - Street 2:
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277
Practice Address - Country:US
Practice Address - Phone:276-546-1182
Practice Address - Fax:276-546-2497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007610378Medicaid
VA493835Medicare Oscar/Certification
VAB06919Medicare UPIN
VAC01115Medicare PIN