Healthcare Provider Details

I. General information

NPI: 1639316623
Provider Name (Legal Business Name): ANDREW WILLIAM VARGA MD/PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MADISON SQUARE NORTH
NEW YORK NY
10010
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL # 3000
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 212-481-1818
  • Fax: 212-523-0498
Mailing address:
  • Phone: 212-987-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number262693
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number262693
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: