Organization
OLD TAPPAN MEDICAL GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN G VARHOL M.D. (PRESIDENT)
(201) 666-1000
Entity
Organization
Contact information
Practice address
215 OLD TAPPAN RD, OLD TAPPAN, NJ 07675-7000
(201) 666-1000
(201) 666-7610
Mailing address
215 OLD TAPPAN RD, OLD TAPPAN, NJ 07675-7000
(201) 666-1000
(201) 666-7610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087710
AETNA CAPITATION NUMBER
—
05
—
2672901
—
NJ
01
—
3695
AETNA CAPITATION NUMBER
—
Enumeration date
08/05/2006
Last updated
09/11/2025
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