Provider Demographics
NPI:1740264498
Name:VAROQUA, SABAH (MD)
Entity type:Individual
Prefix:
First Name:SABAH
Middle Name:
Last Name:VAROQUA
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 1:975 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2722
Mailing Address - Country:US
Mailing Address - Phone:973-778-8666
Mailing Address - Fax:973-778-7559
Practice Address - Street 1:975 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2722
Practice Address - Country:US
Practice Address - Phone:973-778-8666
Practice Address - Fax:973-778-7559
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05921400207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0583847Medicaid
LA1664227Medicaid
LA5W309Medicare ID - Type Unspecified