# OLD TAPPAN MEDICAL GROUP DEPT OF INTERNAL MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083622799
- **Authorized official:** DR. STEPHEN G. VARHOL M.D. (PRESIDENT)
- **Authorized official phone:** (201) 666-1000

## Contact information

- **Practice address:** 215 OLD TAPPAN RD, OLD TAPPAN, NJ 07675-7000
- **Practice address phone:** (201) 666-1000
- **Practice address fax:** (201) 666-7610
- **Mailing address:** 215 OLD TAPPAN RD, OLD TAPPAN, NJ 07675-7000
- **Mailing address phone:** (201) 666-1000
- **Mailing address fax:** (201) 666-7610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 06/29/2010