Provider Demographics
NPI:1780320358
Name:KARIPELIL VARGHESE, GITHU GEORGE
Entity type:Individual
Prefix:
First Name:GITHU GEORGE
Middle Name:
Last Name:KARIPELIL VARGHESE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8537 262ND ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1127
Mailing Address - Country:US
Mailing Address - Phone:516-304-4773
Mailing Address - Fax:
Practice Address - Street 1:8537 262ND ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1127
Practice Address - Country:US
Practice Address - Phone:516-304-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist