Provider Demographics
NPI:1184607525
Name:VARELA, CARLY R (MD)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:R
Last Name:VARELA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 N 20TH ST STE 301
Mailing Address - Street 2:CHCA
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1454
Mailing Address - Country:US
Mailing Address - Phone:215-567-2422
Mailing Address - Fax:215-561-0959
Practice Address - Street 1:CHILDREN'S NATIONAL HEALTH SYSTEM
Practice Address - Street 2:111 MICHIGAN AVE NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-476-4000
Practice Address - Fax:703-531-1590
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2018-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD428392208000000X, 2080P0207X
CT043287208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001432872Medicaid
I35465Medicare UPIN
CT370001584Medicare ID - Type Unspecified