| Doctor Name: | MRS. LOVELY SIJJU VARGHESE |
| NPI Number: | 1306192182 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP012066 |
| Business Practice Address: | 850 Paper Mill Rd Fairview Care Center Of Paper Mill Glenside, PA - 190387833 |
| Business Phone Number: | 2152330920 |
| Business Fax Number: | 2156731894 |
| Mailing Address: | 850 Paper Mill Rd, Fairview Care Center Of Paper Mill Road GLENSIDE |
| State: | PA |
| Postal Code: | 190387833 |
| Phone Number: | 2152330920 |
| Fax Number: | 2156731894 |
| NPI Enumeration Date: | 07/30/2012 |
| NPI Last Update Date: | 03/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | SP012066 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |