Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 043287 | CT |
N | 208000000X | Pediatrician | MD428392 | PA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD428392 | PA |
NPI | 1184607525 |
---|---|
Provider Name | Carly R Varela |
First Address | Philadelphia, PA 19103-1454 |
Second Address | Washington, DC 20010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 17/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001432872 | (05) | CT |
I35465 | (02) |