Provider Demographics
NPI:1457728313
Name:VARNADO, AVIVA B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AVIVA
Middle Name:B
Last Name:VARNADO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AVIVA
Other - Middle Name:M
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 871051
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70187-1051
Mailing Address - Country:US
Mailing Address - Phone:504-722-8377
Mailing Address - Fax:
Practice Address - Street 1:3535 SEVERN AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3482
Practice Address - Country:US
Practice Address - Phone:504-722-8377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPNT.046831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist