Basic Information
| Provider Information | |||||||||
| NPI: | 1639393291 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VARGHESE | ||||||||
| FirstName: | CARA | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 GERMANTOWN RD | ||||||||
| Address2: | SUITE 2B | ||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068105036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037940090 | ||||||||
| FaxNumber: | 2038304614 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 GERMANTOWN RD | ||||||||
| Address2: | SUITE 2B | ||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068105036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037940090 | ||||||||
| FaxNumber: | 2038304614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 03/17/2009 | ||||||||
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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 | 363A00000X | 25MP00072700 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | 25MP00072700 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363A00000X | 002140 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | 002140 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.