MEDICARE: DR. VARAD SHIRISH VYAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	25MA09976400	NJ
2	207R00000X	Internal Medicine Physician	25MA09976400	NJ

General Provider Information

NPI Number	:	1689018962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VARAD SHIRISH VYAS M.D.

Provider Business Mailing Address
First Line	:	223 N VAN DIEN AVE OFC
Second Line	:	HOSPITALIST OFFICE
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-2736
Country	:	US
Telephone Number	:	201-447-8618
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 N VAN DIEN AVE OFC
Second Line	:	HOSPITALIST OFFICE
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-2736
Country	:	US
Telephone Number	:	201-447-8618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2013
Last Update Date	:	12/24/2025

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