Provider Demographics
NPI:1932165230
Name:VARRATI, NICHOLAS VINCENT III (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:VINCENT
Last Name:VARRATI
Suffix:III
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 1:306 W HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-2134
Mailing Address - Country:US
Mailing Address - Phone:330-339-9211
Mailing Address - Fax:330-339-8858
Practice Address - Street 1:306 W HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2134
Practice Address - Country:US
Practice Address - Phone:330-339-9211
Practice Address - Fax:330-339-8858
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050153208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0581400Medicaid
OHA16119Medicare UPIN
0569135Medicare PIN