Provider Demographics
NPI:1508327206
Name:SURESH, VARSHA VALLAPUZHA
Entity type:Individual
Prefix:
First Name:VARSHA
Middle Name:VALLAPUZHA
Last Name:SURESH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-2608
Mailing Address - Country:US
Mailing Address - Phone:210-333-8222
Mailing Address - Fax:201-333-0095
Practice Address - Street 1:26 GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2608
Practice Address - Country:US
Practice Address - Phone:201-333-8222
Practice Address - Fax:201-333-0095
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12136700207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology