Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 20A11711 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | 20A11711 | CA |
Y | 2080P0203X | Pediatric Critical Care Doctor | DO.000206 | LA |
NPI | 1245490432 |
---|---|
Provider Name | Joyce M Varghese |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 13/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00132058 | (05) | MS |
1103497 | (05) | LA |