Basic Information
| Provider Information | |||||||||
| NPI: | 1427355833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VARGHESE | ||||||||
| FirstName: | TEENA | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1030 KINGS HWY N | ||||||||
| Address2: | STE 200 | ||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080341907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889852727 | ||||||||
| FaxNumber: | 8567790211 | ||||||||
| Practice Location | |||||||||
| Address1: | 1123 CAMPUS DR | ||||||||
| Address2: | |||||||||
| City: | MORGANVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077511261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326179797 | ||||||||
| FaxNumber: | 7326178899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2011 | ||||||||
| LastUpdateDate: | 03/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD441933 | PA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.