Organization Active NPI

Michael D Vardy Gynecology and Urogynecology, LLC

  • Gynecology Physician
  • Englewood, NJ
National Provider Identifier
1023264140
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MA07428500 Issued in NJ
Legal business name
MICHAEL D VARDY GYNECOLOGY AND UROGYNECOLOGY, LLC
Practice address
350 Engle St
5 West
Englewood, NJ 07631-1808
Phone
(917) 504-0415
NPI assigned
Aug 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael D Vardy, MD
Title
President
Phone
(646) 345-5249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 25MA07428500 NJ Primary

Addresses

Primary practice location

350 Engle St
5 West
Englewood, NJ 07631-1808

Mailing address

7 Park St
Tenafly, NJ 07670-2217
Phone (917) 504-0415

National Provider Directory

National Provider Directory

Locations

350 Engle St
#5W
Englewood, NJ 07631
Phone (201) 894-3690

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1023264140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PARK ST",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702217",
            "telephone_number": "917-504-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "address_2": "5 WEST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "917-504-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D VARDY GYNECOLOGY AND UROGYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "VARDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-345-5249",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA07428500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.