Old Tappan Medical Group, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

OLD TAPPAN MEDICAL GROUP, PA

Practice address

215 Old Tappan Rd
Old Tappan, NJ 07675-7000

Phone

(201) 666-1000

Fax

(201) 666-7610

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen G Varhol, M.D.

Title

President

Phone

(201) 666-1000

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1912916693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OLD TAPPAN RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757000",
            "telephone_number": "201-666-1000",
            "fax_number": "201-666-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OLD TAPPAN RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757000",
            "telephone_number": "201-666-1000",
            "fax_number": "201-666-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TAPPAN MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "VARHOL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-666-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAPITATION NUMBER",
            "identifier": "3695",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2672901",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAPITATION NUMBER",
            "identifier": "087710",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Valley Vascular Associates
• Donna Gabriella Nucera, LAC
• Olubunmi E Okunlola, MD
• Old Tappan Chiropractic, PA
• Old Tappan Medical Group Dept of Internal Medicine, LLC
• Old Tappan Pediatrics
• Olakunle Kayode Oluwole, M.D.
• Ozzy Sanchez, LCSW
• Helen Papadatos
• Diane M Park, LCSW

• Pediatrics Physician in Old Tappan, NJ
• Providers in Old Tappan, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.