Provider Demographics
NPI:1861133324
Name:PRAMIL, VARSHA
Entity type:Individual
Prefix:
First Name:VARSHA
Middle Name:
Last Name:PRAMIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VARSHA
Other - Middle Name:PRAMIL
Other - Last Name:VANDRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:124 W CONCORD ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-4222
Mailing Address - Country:US
Mailing Address - Phone:717-460-2095
Mailing Address - Fax:
Practice Address - Street 1:800 WASHINGTON ST # 450
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:460-061-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA293164207W00000X
NMRS2025-0180390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology